DR. AMANDA WENZEL KALSTABAKKEN (NPI# 1649819665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649819665 |
| Entity Type | Individual |
| Full Name | DR. AMANDA WENZEL KALSTABAKKEN |
| Credential | PHD |
| Practice Address |
2512 S 7th St Minneapolis MN 55454-1404 |
| Practice Telephone | 6123656777 |
| Practice Fax Number | 6123658001 |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2020-02-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | LP6427 | MN | Behavioral Health & Social Service Providers |
| Street Address |
2512 S 7TH ST |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55454-1404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619950839 | Bradley James Nelson | Orthopaedic Surgery | 2512 S 7th St, Department of Orthopaedics, R200, Minneapolis, MN 55454-1404 | 2005-11-22 |
| 1316548498 | Erin Devine | Speech-Language Pathologist | 2512 S 7th St, Minneapolis, MN 55454-1404 | 2020-11-04 |
| 1689209173 | Megan Fritsch | Occupational Therapist | 2512 S 7th St, Minneapolis, MN 55454-1404 | 2020-03-05 |
| 1528540671 | Emre Josiah Michelle Mauleon | Registered Nurse | 2512 S 7th St, Minneapolis, MN 55454-1404 | 2018-09-05 |
| 1114419793 | Katherine Berglove | Physical Therapist | 2512 S 7th St, Minneapolis, MN 55454 | 2018-05-31 |
| 1811497621 | Kathryn Louise Chappelow | Occupational Therapy Assistant | 2512 S 7th St, Minneapolis, MN 55454-1404 | 2018-02-19 |
| 1255830774 | Tracy Ann Moe | Nurse Practitioner | 2512 S 7th St, Minneapolis, MN 55454 | 2018-02-10 |
| 1558878363 | Nicole Ann Witowski | Registered Nurse | 2512 S 7th St, Minneapolis, MN 55454-1404 | 2018-01-02 |
| 1396258448 | Ashley Relopez | Physical Therapist | 2512 S 7th St, Minneapolis, MN 55454-1404 | 2017-11-13 |
| 1093226326 | Fairview Pharmacy Services LLC | Pharmacy | 2512 S 7th St, Ste 105, Minneapolis, MN 55454-1404 | 2017-10-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194341842 | Bruce Zhang | Student in an Organized Health Care Education/Training Program | 606 24th Ave. S. Suite 200, Minneapolis, MN 55454 | 2020-06-18 |
| 1205456738 | Sara Segner | Student in an Organized Health Care Education/Training Program | Peds Education Office M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 | 2020-04-24 |
| 1417576844 | Sabena Khan | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building. 2450 Riverside Avenue, Minneapolis, MN 55454 | 2020-04-15 |
| 1811525983 | Kayla Joy Solstad | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Bldg., 2450 Riverside Ave, Minneapolis, MN 55454 | 2020-04-01 |
| 1720647126 | Lauren Harasymiw | Student in an Organized Health Care Education/Training Program | Pediatrics Ed. Office, M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-06-10 |
| 1689237448 | Katelyn Marie Adams | Student in an Organized Health Care Education/Training Program | Pediatrics Education Office, M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-04-17 |
| 1285197848 | Adrienne Bruder | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-04-10 |
| 1588142855 | Stewart Graeme Morrison | Student in an Organized Health Care Education/Training Program | Department of Orthopaedics University of Minnesota, 2450 Riverside Ave R200, Minneapolis, MN 55454 | 2018-07-30 |
| 1831682251 | Sherab Tsheringla | Student in an Organized Health Care Education/Training Program | 2450 Riverside Avenue South, Minneapolis, MN 55454 | 2018-06-11 |
| 1669962148 | Pooja Elizabeth Mishra | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building 8950a (campus Delivery C, 2450 Riverside Ave, Minneapolis, MN 55454 | 2018-05-10 |
| Find all providers in zip 55454 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285118687 | Chimei M Lee | Clinical Neuropsychologist | 717 Delaware St Se Ste 340, Minneapolis, MN 55414-2959 | 2018-09-20 |
| 1962750026 | Paul Marshall LLC | Clinical Neuropsychologist | 825 Nicollet Mall Ste 1440, Medical Arts Bldg, Minneapolis, MN 55402-2718 | 2012-08-21 |
| 1780977934 | Samantha Glass | Clinical Neuropsychologist | 701 Park Ave # G8, Minneapolis, MN 55415-1623 | 2011-05-20 |
| 1467660084 | Robin Lee Wetzel | Clinical Neuropsychologist | 1625 Park Ave, Minneapolis, MN 55404-1634 | 2007-05-18 |
| 1912022336 | Learning and Language Specialists, Inc. | Clinical Neuropsychologist | 1405 Lilac Dr N Ste 200, Minneapolis, MN 55422-4546 | 2007-03-21 |
| 1619050028 | Robin Rumsey | Clinical Neuropsychologist | 717 Delaware St Se Ste 240, Minneapolis, MN 55414-2959 | 2006-10-23 |
| 1497837041 | William Thomas O'dowd | Clinical Neuropsychologist | 2720 W 43rd St, Suite 205, Minneapolis, MN 55410-1643 | 2006-10-20 |
| 1568418812 | Christopher James Boys | Clinical Neuropsychologist | 200 Oak St Se, 160 Mcnamara Mcnamara, University of Minnesota Physicians, Minneapolis, MN 55455 | 2006-05-26 |
| 1104476589 | Leslie N Perez | Clinical Neuropsychologist | 701 Park Ave, Minneapolis, MN 55415-1623 | 2019-09-17 |
| 1518432046 | Nicole Arola Anderson | Clinical Neuropsychologist | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2018-10-11 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55454 |
Please comment or provide details below to improve the information on DR. AMANDA WENZEL KALSTABAKKEN.
| 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.