Individual
KIMMY S OBERSTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP, PMHS
Contact information
Practice address
360 SHERMAN ST STE 200, CHILDRENS SPECIALTY CLINIC PSYCHOLOGICAL SERVICES STPL, SAINT PAUL, MN 55102-2567
(651) 220-6720
(651) 220-6707
Mailing address
2910 CENTRE POINTE DRIVE, CHILDRENS HEALTH CARE, ROSEVILLE, MN 55113
(651) 855-2327
(651) 855-2310
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R1115279
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
434716100
—
MN
Enumeration date
08/17/2006
Last updated
08/24/2012
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