Kathleen Ann Fagerlund, CRNA, PHD

Primary specialty

SpecialistTaxonomy code 174400000X

License

R104796-5 Issued in MN

Practice address

1 Veterans Dr # 112a
Minneapolis, MN 55417-2309

Phone

(612) 467-3392

Fax

(612) 467-5887

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518071695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 NEWBERRY AVE N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550821705",
            "telephone_number": "612-467-3392",
            "fax_number": "612-467-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR # 112A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-467-3392",
            "fax_number": "612-467-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGERLUND",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "CRNA, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "R104796-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omolabake Olabisi Fadeyibi
• Todd Faehner
• Jafary Fafara, MD
• Barbara Lynn Fagan, D.C.
• Alice Hannah Rose Fagen, MD
• Shannyn Fagerstrom Schauer
• Shahriar Faghani, MD
• Nancy M a Fahim, MD
• Ahmad M Fahmy, OD
• Kathryn Leigh Fahnel, D.C.

• Specialist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.