NPI 1003408857

The Minnesota Ketamine and Wellness Institute PA

Organisation Anesthesiology Physician Maple Grove, MN

Practice location

Address: 9325 Upland Ln N STE 370, Maple Grove, MN 55369-4463
Phone: (612) 394-8717
Fax: (763) 432-5721

Authorised official

Name: Christena Regena Hatcher
Title: Cfo
Phone: (612) 394-8717

Registered specialties (4)

Anesthesiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207L00000X

Other Anesthesiology providers in Minnesota →

Infusion Therapy Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QI0500X

Other Clinic/Center providers in Minnesota →

Adult Mental Health Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QM0850X

Multi-Specialty Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QM1300X

Registry record

NPI: 1003408857
Entity type: Organization
NPI issued: 3 Feb 2021
Record last updated: 20 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.