MEDICARE: KAYLA MARIE KVELL DNP. APRN, PMHNP-BC

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	2084P0800X	Psychiatry Physician	10730	MN

General Provider Information

NPI Number	:	1194501643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA MARIE KVELL DNP. APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	11280 86TH AVE N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-4510
Country	:	US
Telephone Number	:	612-812-9851
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 S 4TH ST STE 410
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55415-1419
Country	:	US
Telephone Number	:	612-812-9851
Fax Number	:

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

Provider Enumeration Date	:	08/31/2023
Last Update Date	:	10/08/2024

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