Mark Oliver Kragenbring, RN
Individual provider Active NPI Child & Adolescent Psychiatric/Mental Health Registered Nurse · Atwater, MN
NPI 1225348352 · NPPES record last updated Oct 7, 2010
Key facts
- NPI
- 1225348352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X
- License
- R1279678 (MN)
- Practice address
- 5501 Shady Oaks Rd
Atwater, MN 56209-9365 - Phone
- (320) 974-8266
- NPI assigned
- Oct 7, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1279678 | MN | MD | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R1279678 | MN | |
| Child & Adolescent Psychiatric/Mental Health Registered Nurse | 163WP0807X | R1279678 | MN | Yes |
Addresses
Primary practice location
5501 Shady Oaks Rd
Atwater, MN 56209-9365
Mailing address
5501 Shady Oaks Rd
Atwater, MN 56209-9365
Phone (320) 974-8266
Other providers in Atwater, MN
- Taylor Buchtel
- City of Atwater
- Diamond Counseling LLC
- Lucas Dean Krug
- Stephen C Olsen
- Presbyterian Family Foundation
- Tanya Marie Turnock
All providers in Atwater, MN · Child & Adolescent Psychiatric/Mental Health Registered Nurse in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.