Provider Demographics
NPI:1295897759
Name:PFAFF, KURT T (AUD)
Entity type:Individual
Prefix:DR
First Name:KURT
Middle Name:T
Last Name:PFAFF
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10417 EXCELSIOR BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-3421
Mailing Address - Country:US
Mailing Address - Phone:952-931-9144
Mailing Address - Fax:952-931-9510
Practice Address - Street 1:10417 EXCELSIOR BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-3421
Practice Address - Country:US
Practice Address - Phone:952-931-9144
Practice Address - Fax:952-931-9510
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5489231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5G607PFOtherBCBS OF MN
MN45-00793OtherMEDICA