Provider Demographics
NPI:1811408750
Name:KALTHOFF, MADELINE WELTER (PA-C)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:WELTER
Last Name:KALTHOFF
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:MADELINE KALTHOFF, CENTRACARE CLINIC 1200 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303
Mailing Address - Country:US
Mailing Address - Phone:320-252-5131
Mailing Address - Fax:
Practice Address - Street 1:6405 FRANCE AVE S STE W440
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2190
Practice Address - Country:US
Practice Address - Phone:952-927-7004
Practice Address - Fax:952-927-5146
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2020-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant