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NPI Code Detail

MEDICARE: KYLIE THEDENS RN

MEDICARE: KYLIE THEDENS RN
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
1163WM0102XMaternal Newborn Registered Nurse2518259MN

General Provider Information

NPI Number : 1710813456
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLIE THEDENS RN
Provider Business Mailing Address
First Line : 107 13TH AVE NE APT 310
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-3136
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 902 E 26TH ST
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-4514
Country : US
Telephone Number : 612-775-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2026
Last Update Date : 06/22/2026

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Directions to “ KYLIE THEDENS RN” Practice Location

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