Provider Demographics
NPI:1447424924
Name:TIEGS, KRISTIN E (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:E
Last Name:TIEGS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:E
Other - Last Name:LOEWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:301 2ND ST NE
Mailing Address - Street 2:
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-1709
Mailing Address - Country:US
Mailing Address - Phone:952-758-4461
Mailing Address - Fax:952-210-5011
Practice Address - Street 1:212 10TH AVE NE
Practice Address - Street 2:
Practice Address - City:NEW PRAGUE
Practice Address - State:MN
Practice Address - Zip Code:56071-2192
Practice Address - Country:US
Practice Address - Phone:952-758-4461
Practice Address - Fax:952-758-5011
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN50901207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine