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General NPI Number Information
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NPI Number | 1801993340
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Entity Type | Individual
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Provider Name | JENNIFER L KERSTEN MD
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Gender | Female
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Dates
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Enumeration Date | 09/19/2006
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 1221 NICOLLET MALL SUITE 600
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City | MINNEAPOLIS
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State | MN
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Zip | 55403-2444
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Country | US
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Telephone | 612-573-2232
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Fax | 612-573-2274
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Provider Business Mailing Address
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Address Line | 7505 METRO BLVD 400
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City | EDINA
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State | MN
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Zip | 55439-3010
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Country | US
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Telephone | 612-573-2200
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Fax | 612-573-2274
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | T102711
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License Number State | MN
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