Provider Demographics
NPI:1770115610
Name:DERMATOLOGY PARTNERS PLLC
Entity type:Organization
Organization Name:DERMATOLOGY PARTNERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-231-2004
Mailing Address - Street 1:4270 MAINE AVE SE STE 300
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-6936
Mailing Address - Country:US
Mailing Address - Phone:507-206-3211
Mailing Address - Fax:507-206-3040
Practice Address - Street 1:4270 MAINE AVE SE STE 300
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-6936
Practice Address - Country:US
Practice Address - Phone:507-206-3211
Practice Address - Fax:507-206-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-09
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty