Provider Demographics
NPI:1043486590
Name:WOERNER, KATTI LAUREN (DO)
Entity Type:Individual
Prefix:
First Name:KATTI
Middle Name:LAUREN
Last Name:WOERNER
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:717 DELAWARE ST SE
Mailing Address - Street 2:MAIL CODE 1932
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2959
Mailing Address - Country:US
Mailing Address - Phone:612-624-9444
Mailing Address - Fax:612-626-3840
Practice Address - Street 1:14500 99TH AVE N
Practice Address - Street 2:MEDICAL SPECIALTY CLINIC
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4730
Practice Address - Country:US
Practice Address - Phone:763-898-1000
Practice Address - Fax:763-898-1323
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2014-05-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN54643207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN19554OtherRESIDENT PERMIT