Provider Demographics
NPI:1982969614
Name:KLETT, KRISTI LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:LYNN
Last Name:KLETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10150 INDIGO DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-1208
Mailing Address - Country:US
Mailing Address - Phone:952-938-2377
Mailing Address - Fax:952-938-2377
Practice Address - Street 1:10150 INDIGO DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-1208
Practice Address - Country:US
Practice Address - Phone:952-938-2377
Practice Address - Fax:952-938-2377
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23572174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist