Provider Demographics
NPI:1487403192
Name:DOHMEIER, KRISTIN NOEL (RN)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NOEL
Last Name:DOHMEIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4822 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-1034
Mailing Address - Country:US
Mailing Address - Phone:612-275-7810
Mailing Address - Fax:
Practice Address - Street 1:2562 7TH AVE E STE 201
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55109-3037
Practice Address - Country:US
Practice Address - Phone:651-330-2550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN163691-0163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse