Provider Demographics
NPI:1750538245
Name:BHEND, KRISTY MARY GEHLING (OD)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:MARY GEHLING
Last Name:BHEND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 BROADWAY AVE S STE 400
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-6259
Mailing Address - Country:US
Mailing Address - Phone:507-322-0044
Mailing Address - Fax:844-755-6392
Practice Address - Street 1:2650 BROADWAY AVE S STE 400
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-6259
Practice Address - Country:US
Practice Address - Phone:507-322-0044
Practice Address - Fax:844-755-6392
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2475152W00000X
CO3019152W00000X
MN3149152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0402325Medicaid
IA0402325Medicaid
IA145770002Medicare PIN