Matilda Kla-Diihbah, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

L047935-6 Issued in MN

Practice address

14096 Gadwall LN
Rogers, MN 55374-8769

Phone

(612) 708-0910

NPI assigned

Aug 28, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1282953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282953600000",
    "number": "1942516893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD",
            "address_2": "SUITE 700",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161222",
            "telephone_number": "612-708-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14096 GADWALL LN",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553748769",
            "telephone_number": "612-708-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLA-DIIHBAH",
        "first_name": "MATILDA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-28",
        "last_updated": "2010-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "L047935-6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLASS HOME HEALTH PROFESIONAL AGENCY",
            "identifier": "348032",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcus Kasper
• Gerald A. Kern, M.A. PSYCHOLOGIST
• Shabri Christine Kilgo
• Stephanie King
• Kevin J Kirlin, O.D.
• Jennifer Michelle Knapp, LMFT
• Katelyn Emily Knaus, DC
• Knudson Chiropractic PLLC
• Eric Gregory Knudson, D.C.
• Marisa Kolasa

• Licensed Practical Nurse in Rogers, MN
• Providers in Rogers, MN by specialty
• Licensed Practical Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2010; 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.