Provider Demographics
NPI:1659691673
Name:PEHL, KATIE L (CNM)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:L
Last Name:PEHL
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Gender:F
Credentials:CNM
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-883-5375
Mailing Address - Fax:952-883-5395
Practice Address - Street 1:8170 33RD AVE S - MS 21110Q
Practice Address - Street 2:HEALTHPARTNERS FLOATING CLINIC C/O PHYSICIANS SERVICES
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55440-1309
Practice Address - Country:US
Practice Address - Phone:952-883-5375
Practice Address - Fax:952-883-5395
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2011-12-08
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Provider Licenses
StateLicense IDTaxonomies
MNR184081-6367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife