Provider Demographics
NPI:1659047520
Name:KITHINJI, STELLA KANANA (APRN)
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:KANANA
Last Name:KITHINJI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:STELLA
Other - Middle Name:KANANA
Other - Last Name:KITHINJI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, APRN, NP-C
Mailing Address - Street 1:7115 148TH LN NW
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-4655
Mailing Address - Country:US
Mailing Address - Phone:763-218-4985
Mailing Address - Fax:
Practice Address - Street 1:7231 SUNWOOD DR NW
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-5190
Practice Address - Country:US
Practice Address - Phone:763-236-0000
Practice Address - Fax:763-236-0025
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8413363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN00000000OtherN/A