Provider Demographics
NPI:1134212707
Name:DANIELSON KRIPPNER, AMY KELLY (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:KELLY
Last Name:DANIELSON KRIPPNER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 4TH STREET SOUTHWEST
Mailing Address - Street 2:SUITE 11
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201
Mailing Address - Country:US
Mailing Address - Phone:320-214-7082
Mailing Address - Fax:320-235-8059
Practice Address - Street 1:2653 COUNTY ROAD 74
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-2205
Practice Address - Country:US
Practice Address - Phone:320-420-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102487225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN64-05015OtherMEDICA
MN165554OtherUCARE
MN106177OtherHEALTH PARTNERS
MN507468100Medicaid
MN412M2CHOtherBLUE CROSS/BLUE SHIELD