MEDICARE: VITALIY PAVLOVICH KOVDIY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	ARNP.AP.70132652-NP	WA
2	363LF0000X	Family Nurse Practitioner	13629	MN

General Provider Information

NPI Number	:	1013879162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VITALIY PAVLOVICH KOVDIY

Provider Business Mailing Address
First Line	:	13201 E MANOR BLVD
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55337-2093
Country	:	US
Telephone Number	:	952-649-2735
Fax Number	:

Provider Business Practice Location Address
First Line	:	13201 E MANOR BLVD
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55337-2093
Country	:	US
Telephone Number	:	952-649-2735
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	06/03/2026

Similar Medicare Providers

1952939373 — BRANDON FREE
Practice Location Address:

303 E NICOLLET BLVD STE 330
BURNSVILLE, MN
55337-4594

Practice Phone: 952-209-9273
Practice Fax:

1689719940 — FAIRVIEW PHARMACY SERVICES LLC
Practice Location Address:

303 E NICOLLET BLVD , STE 200
BURNSVILLE, MN
55337-4834

Practice Phone: 952-460-4099
Practice Fax: 952-892-7115

1164164497 — SONIA NIKOLAYEVNA RUNKEL PA
Practice Location Address:

1000 W. 140TH ST. , SUITE #100
BURNSVILLE, MN
55337

Practice Phone: 952-435-0303
Practice Fax: 952-892-5166

1750465993 — INFINITE HEALTH COLLABORATIVE, PA
Practice Location Address:

1000 W 140TH STREET , SUITE 201
BURNSVILLE, MN
55337

Practice Phone: 952-808-3000
Practice Fax: 952-808-3001

1356274963 — ZOE ZANELLA
Practice Location Address:

12400 PORTLAND AVE STE 195
BURNSVILLE, MN
55337-6805

Practice Phone: 952-443-4600
Practice Fax: 952-443-4604

1407693526 — MIRANDA LOU KRENTZ
Practice Location Address:

1517 HIGHWAY 13 E
BURNSVILLE, MN
55337-2917

Practice Phone: 612-756-9107
Practice Fax:

Directions to “ VITALIY PAVLOVICH KOVDIY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.