Provider Demographics
NPI:1003141904
Name:BEERMAN, KRISTA MARIE (CMT)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:MARIE
Last Name:BEERMAN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25125 110TH ST
Mailing Address - Street 2:
Mailing Address - City:FULDA
Mailing Address - State:MN
Mailing Address - Zip Code:56131-1275
Mailing Address - Country:US
Mailing Address - Phone:507-360-2611
Mailing Address - Fax:
Practice Address - Street 1:108 N SAINT PAUL AVE
Practice Address - Street 2:
Practice Address - City:FULDA
Practice Address - State:MN
Practice Address - Zip Code:56131-9401
Practice Address - Country:US
Practice Address - Phone:507-425-0025
Practice Address - Fax:507-425-0036
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist