Individual
MS. KRISTEN D BALLENTHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1040 GRAND AVE, SAINT PAUL, MN 55105-3001
(866) 389-2727
Mailing address
449 COMMERCE DRIVE, WOODBURY, MN 55125
(651) 239-1874
(651) 731-0904
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10908
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207836
MEDICARE ID- COOK
IL
01
—
207848
MEDICARE ID DUPAGE
IL
Enumeration date
11/09/2007
Last updated
10/14/2025
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