Basic Information
| Provider Information | |||||||||
| NPI: | 1407289549 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUGHLETT | ||||||||
| FirstName: | KRISTI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7551 9TH ST N | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | OAKDALE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551286629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6517484338 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1700 TOWER DR W | ||||||||
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| City: | STILLWATER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550827511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6514398540 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2013 | ||||||||
| LastUpdateDate: | 08/13/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 9456 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.