Provider Demographics
NPI:1184698052
Name:KNUTSON, HELEN C (PNP)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:C
Last Name:KNUTSON
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:CORA
Other - Middle Name:
Other - Last Name:KNUTSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8100 34TH AVE S
Mailing Address - Street 2:21110Q
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1672
Mailing Address - Country:US
Mailing Address - Phone:763-587-4600
Mailing Address - Fax:763-587-4615
Practice Address - Street 1:15245 BLUEBIRD ST NW
Practice Address - Street 2:MAIL STOP 39200A
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-3554
Practice Address - Country:US
Practice Address - Phone:763-712-6000
Practice Address - Fax:763-712-6090
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0976024363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN931230700Medicaid
S91349Medicare UPIN
500001347Medicare ID - Type Unspecified