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Organization
THE MINNESOTA KETAMINE AND WELLNESS INSTITUTE PA
Active
Organization
THE MINNESOTA KETAMINE AND WELLNESS INSTITUTE PA
Active
Other names
The Minnesota Ketamine and Wellness Institue, P.A., The Minnesota and Ketamine Wellness Institute
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTENA REGENA HATCHER CRNA (CFO)
(612) 394-8717
Entity
Organization
Contact information
Practice address
9325 UPLAND LN N STE 370, MAPLE GROVE, MN 55369-4463
(612) 394-8717
(763) 432-5721
Mailing address
9325 UPLAND LN N STE 370, MAPLE GROVE, MN 55369-4463
(612) 394-8717
(763) 432-5721
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
Other
Enumeration date
02/03/2021
Last updated
08/20/2021
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