Basic Information
| Provider Information | |||||||||
| NPI: | 1518631928 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAIKO | ||||||||
| FirstName: | KATELYN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 255 WESTERN AVE N APT 402 | ||||||||
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| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551024715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512460652 | ||||||||
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| Practice Location | |||||||||
| Address1: | 640 JACKSON ST | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551012502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512546512 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2021 | ||||||||
| LastUpdateDate: | 11/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 2125569 | MN | N | Nursing Service Providers | Registered Nurse | 367500000X | 2633 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.