MEDICARE: MR. ANDREW KERN ROSDHAL APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11572	MN

General Provider Information

NPI Number	:	1770325763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW KERN ROSDHAL APRN

Provider Business Mailing Address
First Line	:	13792 REIMER DR N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-2219
Country	:	US
Telephone Number	:	763-458-9494
Fax Number	:

Provider Business Practice Location Address
First Line	:	13792 REIMER DR N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-2219
Country	:	US
Telephone Number	:	763-458-9494
Fax Number	:

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

Provider Enumeration Date	:	06/10/2024
Last Update Date	:	01/19/2026

Similar Medicare Providers

1386366532 — MODERN KETAMINE CLINIC
Practice Location Address:

13792 REIMER DR N
MAPLE GROVE, MN
55311-2219

Practice Phone: 763-347-2100
Practice Fax: 763-333-7174

1427921295 — THE MODERN EXPERIENCE CLINIC LLC
Practice Location Address:

13792 REIMER DR N
MAPLE GROVE, MN
55311-2219

Practice Phone: 763-464-9061
Practice Fax: 763-333-7174

1205384898 — EMILY SAUR DPT
Practice Location Address:

445 MAPLE ST
PALO ALTO, CA
94301-2219

Practice Phone: 916-857-9378
Practice Fax:

1639706112 — ANNAMARGARET STEC
Practice Location Address:

445 MAPLE ST
PALO ALTO, CA
94301-2219

Practice Phone: 866-839-6979
Practice Fax:

1700403482 — CHRISTINE LAZARO DPT
Practice Location Address:

445 MAPLE ST
PALO ALTO, CA
94301-2219

Practice Phone: 866-839-6979
Practice Fax:

1912515818 — WEN JONG ERIC SOK DPT
Practice Location Address:

445 MAPLE ST
PALO ALTO, CA
94301-2219

Practice Phone: 213-369-0179
Practice Fax:

Directions to “ MR. ANDREW KERN ROSDHAL APRN” 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.