Basic Information
Provider Information
NPI: 1740510536
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KNUDSON
FirstName: BARBARA
MiddleName: ANNE
NamePrefix: MS.
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
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OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P.O. BOX 209036
Address2: SHRINER'S HOSPITALS FOR CHILDREN TWIN CITIES
City: DALLAS
State: TX
PostalCode: 753209036
CountryCode: US
TelephoneNumber: 8132818478
FaxNumber: 8132818113
Practice Location
Address1: 2025 EAST RIVER PKWY
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 55414
CountryCode: US
TelephoneNumber: 6125966216
FaxNumber: 6123395954
Other Information
ProviderEnumerationDate: 12/30/2009
LastUpdateDate: 04/04/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XP0200X102063MNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics

No ID Information.


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