Individual provider Active NPI

Kindra Jo Lesnau, APRN, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hugo, MN
National Provider Identifier
1104581842
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8682 Issued in MN
Practice address
4638 Victor Path North, Suite 900
Hugo, MN 55038
Phone
(651) 364-3839
Fax
(651) 364-3840
NPI assigned
Nov 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8682 MN Primary

Addresses

Primary practice location

4638 Victor Path North, Suite 900
Hugo, MN 55038

Mailing address

15026 Farnham Ave N
Hugo, MN 55038-9003
Phone (612) 237-5877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211201001113 MN Practitioner - Nurse Practitioner 8325438674 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8682MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
KL Wellness & Metabolic Health, PLLC Current Accepting new patients
Nystrom & Associates, LTD CurrentSince Nov 29, 2021 Accepting new patients

Locations

4638 Victor Path
Ste 900
Hugo, MN 55038
Phone (651) 270-7012

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1104581842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15026 FARNHAM AVE N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550389003",
            "telephone_number": "612-237-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4638 VICTOR PATH NORTH, SUITE 900",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "55038",
            "telephone_number": "651-364-3839",
            "fax_number": "651-364-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESNAU",
        "first_name": "KINDRA",
        "middle_name": "JO",
        "credential": "APRN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hugo, MN

Sources for this page

Verify at the official NPI Registry.