Provider Demographics
NPI:1609144187
Name:BLENINGER-SUNDAR, KRISTEN M (NP-C)
Entity Type:Individual
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First Name:KRISTEN
Middle Name:M
Last Name:BLENINGER-SUNDAR
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Gender:F
Credentials:NP-C
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Mailing Address - Street 1:5775 WAYZATA BOULEVARD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SAINT LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2687
Mailing Address - Country:US
Mailing Address - Phone:952-542-8553
Mailing Address - Fax:952-513-6880
Practice Address - Street 1:5775 WAYZATA BOULEVARD
Practice Address - Street 2:SUITE 600
Practice Address - City:SAINT LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2687
Practice Address - Country:US
Practice Address - Phone:952-835-9777
Practice Address - Fax:952-835-9830
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2022-05-04
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Provider Licenses
StateLicense IDTaxonomies
MNR 164279-7363LA2200X
MN2067363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health