TROY PATRICK KITTLESON


Address: 3400 W 66th St, #290, Bloomington, MN 55435-2111
Phone: 9528363637

TROY PATRICK KITTLESON (NPI# 1801865084) 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) 1801865084
Entity Type Individual
Full Name TROY PATRICK KITTLESON
Credential GNP
Practice Address 3400 W 66th St
#290
Bloomington
MN 55435-2111
Mailing Address 10725 Aquila Ave S
Bloomington
MN 55438-2226
Practice Telephone 9528363637
Enumeration Date 2006-03-17
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
R1394980 MN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 3400 W 66TH ST
#290
City BLOOMINGTON
State MN
Zip Code 55435-2111

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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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Competitor

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City BLOOMINGTON
Zip Code 55435

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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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