1346265279 NPI number — KATHLEEN J. FEIL, PHD, LP, PLC

Table of content: (NPI 1346265279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346265279 NPI number — KATHLEEN J. FEIL, PHD, LP, PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KATHLEEN J. FEIL, PHD, LP, PLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346265279
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/03/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 163
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARINE ON SAINT CROIX
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55047-0163
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-308-5581
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
189 EGRET LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARINE ON SAINT CROIX
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55047-8641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-308-5581
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/13/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FEIL
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
JEAN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
651-308-5581

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  LP4051 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 097L7FE . This is a "BCBS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 97480 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".