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NPI Code Detail

MEDICARE: KATHLEEN T PFAFF CNM

MEDICARE: KATHLEEN T PFAFF CNM
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
1163W00000XRegistered Nurse1680212MN
2367A00000XAdvanced Practice Midwife0048MN

General Provider Information

NPI Number : 1770549404
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN T PFAFF CNM
Provider Business Mailing Address
First Line : 701 PARK AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55415-1623
Country : US
Telephone Number : 612-873-3000
Fax Number :
Provider Business Practice Location Address
First Line : 7650 ZANE AVE N
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55443-3151
Country : US
Telephone Number : 612-873-6963
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2006
Last Update Date : 08/12/2025

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Directions to “ KATHLEEN T PFAFF CNM” Practice Location

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