Provider Demographics
NPI:1245320753
Name:OKRINA-KIBIRA, LUANN M (NP)
Entity type:Individual
Prefix:
First Name:LUANN
Middle Name:M
Last Name:OKRINA-KIBIRA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:612-302-8200
Mailing Address - Fax:
Practice Address - Street 1:1020 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-2504
Practice Address - Country:US
Practice Address - Phone:612-302-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR111536-3163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN500769OtherFAIRVIEW
MN037R2KIOtherBCBS
MN1025780OtherPREFERRED ONE
MN151283OtherU CARE
MN433983500Medicaid
MN07-01401OtherMEDICA-CHOICE
1344488OtherARAZ
MNHP32923OtherHEALTH PARTNERS
MN433983500Medicaid
P15952Medicare UPIN