Provider Demographics
NPI:1083056055
Name:BENEDICT, KRISTEN ANNE (ACNP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANNE
Last Name:BENEDICT
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ANNE
Other - Last Name:SEAQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 17370
Mailing Address - Street 2:LOT #1710
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-0370
Mailing Address - Country:US
Mailing Address - Phone:952-297-6912
Mailing Address - Fax:
Practice Address - Street 1:500 HARVARD ST SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0363
Practice Address - Country:US
Practice Address - Phone:952-273-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3488363L00000X
MNR173454-0363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care