Provider Demographics
NPI:1851049027
Name:MROZEK, KRISTEN KAY (FNP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:KAY
Last Name:MROZEK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:RANDALL
Mailing Address - State:MN
Mailing Address - Zip Code:56475-2471
Mailing Address - Country:US
Mailing Address - Phone:218-232-8228
Mailing Address - Fax:
Practice Address - Street 1:251 COUNTY ROAD 120
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4872
Practice Address - Country:US
Practice Address - Phone:320-202-8949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9045363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care