Provider Demographics
NPI:1043459290
Name:SCHULTZ, KRISTIANNE (LAC, DIPL OM)
Entity Type:Individual
Prefix:
First Name:KRISTIANNE
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E 28TH ST
Mailing Address - Street 2:MR 22115
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-3723
Mailing Address - Country:US
Mailing Address - Phone:612-863-3333
Mailing Address - Fax:612-863-9019
Practice Address - Street 1:800 E 28TH ST
Practice Address - Street 2:MR 22115
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3723
Practice Address - Country:US
Practice Address - Phone:612-863-3333
Practice Address - Fax:612-863-9019
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1475171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist