Provider Demographics
NPI:1831842665
Name:BUENDORF, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BUENDORF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:DIANE
Other - Last Name:KREINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3464 WASHINGTON DR STE 110
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1438
Mailing Address - Country:US
Mailing Address - Phone:651-405-6716
Mailing Address - Fax:
Practice Address - Street 1:3464 WASHINGTON DR STE 110
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-1438
Practice Address - Country:US
Practice Address - Phone:651-405-6716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1449945163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse