Basic Information
| Provider Information | |||||||||
| NPI: | 1922079102 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEHNE | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MPT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | JESPERSEN | ||||||||
| OtherFirstName: | KRISTIN | ||||||||
| OtherMiddleName: | A | ||||||||
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| OtherCredential: | MPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 150 ST. ANDREWS COURT | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | MANKATO | ||||||||
| State: | MN | ||||||||
| PostalCode: | 56001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5073885437 | ||||||||
| FaxNumber: | 5073882108 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 ST. ANDREWS COURT | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | MANKATO | ||||||||
| State: | MN | ||||||||
| PostalCode: | 56001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5073885437 | ||||||||
| FaxNumber: | 5073882108 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2006 | ||||||||
| LastUpdateDate: | 04/15/2015 | ||||||||
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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 | 5891 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 14F98JE | 01 | MN | BCBS INDIVID PROVIDER # | OTHER | 6407137 | 01 | MN | MEDICA INDIVID PROVIDER # | OTHER |