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NPI Code Detail

MEDICARE: KRISTEN O HANSBERRY MD

MEDICARE:   KRISTEN O HANSBERRY  MD
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
1207Q00000XFamily Medicine Physician38879MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
138879OTHERMNMEDICAL LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215936216
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN O HANSBERRY MD
Provider Business Mailing Address
First Line : 7801 E BUSH LAKE RD STE 400
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55439-3113
Country : US
Telephone Number : 952-283-3162
Fax Number : 866-991-7241
Provider Business Practice Location Address
First Line : 7801 E BUSH LAKE RD STE 400
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55439-3113
Country : US
Telephone Number : 952-283-3162
Fax Number : 866-991-7241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 08/16/2019

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Directions to “ KRISTEN O HANSBERRY MD” Practice Location

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