Kristine Fasnacht Fumia, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

2041 Issued in MN

Practice address

513 Main Street
Ste 1
Madison Lake, MN 56063

Phone

(507) 737-0009

NPI assigned

Oct 4, 2023

Last updated

Oct 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1336929405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94",
            "city": "MADISON LAKE",
            "state": "MN",
            "postal_code": "560630094",
            "telephone_number": "507-373-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 MAIN STREET",
            "address_2": "STE 1",
            "city": "MADISON LAKE",
            "state": "MN",
            "postal_code": "56063",
            "telephone_number": "507-737-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUMIA",
        "first_name": "KRISTINE",
        "middle_name": "FASNACHT",
        "name_prefix": "Ms.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "OH",
            "license": "240",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "2041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Donald Ackerman, PHARMACIST
• Alyssa Baker, LICSW
• Bryan D. Johnson, DDS, PA
• Bulldog Adventures, PLLC (Madison Lake Family Dental Care)
• Christina Simonette DDS, PLLC
• Jennifer Alexandria Gerfen, CPM, LM
• Grace Margaret Hermer, OTR/L
• Kimberly Kopischke
• Breanna Kruckeberg, DMD
• Theresa Sue Olness

• Acupuncturist in Madison Lake, MN
• Providers in Madison Lake, MN by specialty
• Acupuncturist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.