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General NPI Number Information
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NPI Number | 1992181556
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Entity Type | Individual
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Provider Name | KRISTINE E WESTGARD PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/06/2015
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 3300 OAKDALE AVE N
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City | ROBBINSDALE
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State | MN
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Zip | 55422
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Country | US
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Telephone | 763-581-6555
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Fax | 763-581-4771
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Provider Business Mailing Address
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Address Line | 9201 WEST BROADWAY AVE SUITE 601
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City | BROOKLYN PARK
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State | MN
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Zip | 55445
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Country | US
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Telephone | 763-587-7900
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Fax | 763-587-7066
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 11862
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 11862
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License Number State | MN
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