Provider Demographics
NPI:1790061877
Name:BEER, KRISTINE MARIE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:MARIE
Last Name:BEER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1772 STEIGER LAKE LN
Mailing Address - Street 2:PO BOX 34
Mailing Address - City:VICTORIA
Mailing Address - State:MN
Mailing Address - Zip Code:55386-7723
Mailing Address - Country:US
Mailing Address - Phone:952-443-9888
Mailing Address - Fax:
Practice Address - Street 1:1772 STEIGER LAKE LN
Practice Address - Street 2:SUITE 100
Practice Address - City:VICTORIA
Practice Address - State:MN
Practice Address - Zip Code:55386-7723
Practice Address - Country:US
Practice Address - Phone:952-443-9888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7493235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1311578OtherCIGNA
169036OtherUCARE
4600402OtherMEDICA
76842OtherHEALTPARTNERS
78B64KIOtherBCBS MN
16154051OtherFISERV
565581028803OtherPREFERRED ONE
MN001442700Medicaid