Kiirsten Rakers, BS
Individual provider Active NPI Physical Therapist · Jordan, MN
NPI 1811038797 · NPPES record last updated Aug 1, 2007
Key facts
- NPI
- 1811038797
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 100 Hope Ave
Jordan, MN 55352-1802 - Phone
- (952) 492-8470
- Fax
- (952) 492-3880
- NPI assigned
- Feb 12, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070013879 | IL | MD | Physical Therapist |
| 8002 | MN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minnesota River Valley Special Education Cooperative | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | IL | Yes |
Addresses
Primary practice location
100 Hope Ave
Jordan, MN 55352-1802
Mailing address
100 Hope Ave
Jordan, MN 55352-1802
Phone (952) 492-8470
Other providers in Jordan, MN
- Penney Family Chiropractic, LLC
- Hollie Penney
- Scott Charles Penney
- Liza Antoinette Jain Phu
- Amanda Preiner
- Alicia Ray
- Ruby Sky Therapy and Wellness
- Karis Rygg
- Lydia Schmidt
- Ashtyn Silva
All providers in Jordan, MN · Physical Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2007. 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.