Provider Demographics
NPI:1174877674
Name:KARN, KELLY SKJEI (DC)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:SKJEI
Last Name:KARN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6041 W 94TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-1523
Mailing Address - Country:US
Mailing Address - Phone:612-554-1983
Mailing Address - Fax:
Practice Address - Street 1:5300 HYLAND GREENS DR
Practice Address - Street 2:STE 110
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-3933
Practice Address - Country:US
Practice Address - Phone:612-554-1983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor