Provider Demographics
NPI:1518602820
Name:CHIEN, KRISTINA TESTER-KLASHNYA (MD, JD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:TESTER-KLASHNYA
Last Name:CHIEN
Suffix:
Gender:F
Credentials:MD, JD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1555 NORTHWAY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4913
Mailing Address - Country:US
Mailing Address - Phone:320-240-3157
Mailing Address - Fax:320-240-3165
Practice Address - Street 1:1555 NORTHWAY DR STE 200
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4913
Practice Address - Country:US
Practice Address - Phone:320-240-3157
Practice Address - Fax:320-240-3165
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN75622207Q00000X
MN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty