Provider Demographics
NPI:1487009817
Name:HESS, KALLI AMBER (MD)
Entity Type:Individual
Prefix:
First Name:KALLI
Middle Name:AMBER
Last Name:HESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14001 RIDGEDALE DR #100
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1781
Mailing Address - Country:US
Mailing Address - Phone:952-473-0211
Mailing Address - Fax:952-473-7908
Practice Address - Street 1:111 HUNDERTMARK RD #420
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-1459
Practice Address - Country:US
Practice Address - Phone:952-448-3847
Practice Address - Fax:952-448-5083
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN66080208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics