Provider Demographics
NPI:1538672548
Name:DURIE, KJERSTIN G (PA-C)
Entity Type:Individual
Prefix:
First Name:KJERSTIN
Middle Name:G
Last Name:DURIE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7235 OHMS LN
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2148
Mailing Address - Country:US
Mailing Address - Phone:952-841-2345
Mailing Address - Fax:952-841-2346
Practice Address - Street 1:683 BIELENBERG DR STE 103
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-1711
Practice Address - Country:US
Practice Address - Phone:952-841-2345
Practice Address - Fax:952-841-2346
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN12539363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant