Provider Demographics
NPI:1518109172
Name:KAPFHAMER, KRISTY A (MD)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:A
Last Name:KAPFHAMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:ANN
Other - Last Name:JUEDES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:613-262-5000
Mailing Address - Fax:
Practice Address - Street 1:121 S 8TH ST STE 600
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2825
Practice Address - Country:US
Practice Address - Phone:612-333-4822
Practice Address - Fax:319-730-7368
Is Sole Proprietor?:No
Enumeration Date:2009-03-28
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI55182-20207V00000X
390200000X
MN63381207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program