KIMMY S OBERSTAR


Address: 360 Sherman St Ste 200, Childrens Specialty Clinic Psychological Services Stpl, Saint Paul, MN 55102-2567
Phone: 6512206720

KIMMY S OBERSTAR (NPI# 1043323678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043323678
Entity Type Individual
Full Name KIMMY S OBERSTAR
Credential CPNP, PMHS
Practice Address 360 Sherman St Ste 200
Childrens Specialty Clinic Psychological Services Stpl
Saint Paul
MN 55102-2567
Mailing Address 2910 Centre Pointe Drive
Childrens Health Care
Roseville
MN 55113
Practice Telephone 6512206720
Practice Fax Number 6512206707
Mailing Telephone 6518552327
Mailing Fax Number 6518552310
Enumeration Date 2006-08-17
Last Update Date 2012-08-24
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
R1115279 MN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN 434716100 05

Office Location

Street Address 360 SHERMAN ST STE 200
CHILDRENS SPECIALTY CLINIC PSYCHOLOGICAL SERVICES STPL
City SAINT PAUL
State MN
Zip Code 55102-2567

Providers in the same location

NPI Name Taxonomy Address Enumeration
1619461597 Sandra Ahumada Psychologist 360 Sherman St Ste 200, Saint Paul, MN 55102 2018-06-14
1033459250 Sarah Jacobs Nurse Practitioner 360 Sherman St Ste 200, Saint Paul, MN 55102-2567 2013-02-25
1538427315 Claudia Campo-soria Psychiatry & Neurology 360 Sherman St Ste 200, Saint Paul, MN 55102-2567 2012-04-30
1952586745 Kathleen Woods Hoogerhyde Psychologist 360 Sherman St Ste 200, Saint Paul, MN 55102-2567 2007-12-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1720623366 Ning Wu Acupuncturist Tcm Health Center, 613 Grand Ave., St. Paul, MN 55102 2019-11-07
1730730615 Tianwei Guo Acupuncturist 613 Grand Avenue, Saint Paul, MN 55102 2019-09-23
1194374850 Justin Crawford Diehl Counselor 976 Juno Avenue, Saint Paul, MN 55102 2019-09-05
1699329169 Elisabeth Johanna Wurtmann Genetic Counselor, MS 310 N Smith Avenue Suite 300, Saint Paul, MN 55102 2019-08-01
1265907083 Lillia Budd Nurse Practitioner 225 Smith Ave N - Suite 400, Mail Route 65400, Saint Paul, MN 55102 2018-10-08
1922505098 Women of Nations Substance Abuse Rehabilitation Facility 73 Leech Street, St. Paul, MN 55102 2018-04-06
1609371939 Courtney Marie Klinkhammer Student in an Organized Health Care Education/Training Program 1026 West Seventh Street, St. Paul, MN 55102 2018-03-28
1427429372 Compass Pathology and Consulting Clinical Medical Laboratory 360 Sherman St Suite 400b, St. Paul, MN 55102 2015-10-16
1639550494 Daniel Delapp Speech-Language Pathologist United Hospital 333 Smith Avenue N, Mail Route 60104, St. Paul, MN 55102 2015-06-17
1124419940 Suzanne Carl Speech-Language Pathologist 360 Colborne Avenue, St. Paul, MN 55102 2015-02-16
Find all providers in zip 55102

Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1538644562 Angela Ashton Nurse Practitioner 345 Smith Ave N Ste 404, Saint Paul, MN 55102-2346 2018-09-25
1558865295 Meghan Kerry Deyo Nurse Practitioner 1804 7th St W Ste 200, Saint Paul, MN 55116-2300 2018-03-19
1811323348 Karen Kay Hoyer Nurse Practitioner 310 Smith Ave N Ste 480, Saint Paul, MN 55102 2013-09-16
1255353843 Kimberly Lynn Berg Nurse Practitioner 225 Smith Ave N Ste 201, Saint Paul, MN 55102-2697 2006-07-24
1194788810 Janet Lowe Nurse Practitioner 360 Colborne St, Saint Paul, MN 55102-3228 2006-04-11
1184236739 Anna Rauch Nurse Practitioner 200 University Ave E, Saint Paul, MN 55101-2507 2020-08-17
1699334904 Jessica Determan Nurse Practitioner 205 Wabasha St S, Saint Paul, MN 55107-1805 2019-06-10
1104388644 Cassandra Hoshor Nurse Practitioner 345 Smith Ave N, Saint Paul, MN 55102-2346 2019-04-03
1083191522 Ikran Omar Hussein Nurse Practitioner 345 Smith Ave N, Saint Paul, MN 55102-2346 2018-07-27
1578067039 Alison Beth Wohlhuter Nurse Practitioner 1804 7th St W Ste 200, Saint Paul, MN 55116-2300 2018-03-20
Find all providers in SAINT PAUL

Competitor

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City SAINT PAUL
Zip Code 55102

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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