Provider Demographics
NPI:1851466783
Name:STRANDBERG, KATHERYN ANN (PT)
Entity Type:Individual
Prefix:
First Name:KATHERYN
Middle Name:ANN
Last Name:STRANDBERG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 33RD ST S STE 210
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-9668
Mailing Address - Country:US
Mailing Address - Phone:320-240-6955
Mailing Address - Fax:320-240-8089
Practice Address - Street 1:1301 33RD ST S STE 210
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-9668
Practice Address - Country:US
Practice Address - Phone:320-240-6955
Practice Address - Fax:320-240-8089
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4292225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN043T1STOtherBLUE CROSS BLUE SHIELD
MN081509800Medicaid
MNHP34248OtherHEALTHPARTNERS
MN64002293OtherSELECT CARE
MN264M1NOOtherBLUE CROSS BLUE SHIELD OF MN
MN6402293OtherMEDICA
MN650023332Medicare PIN
MN043T1STOtherBLUE CROSS BLUE SHIELD
MN081509800Medicaid