Individual
KIMBERLY C STOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-6700
Mailing address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15318
MN
363A00000X
Physician Assistant
PA8921
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110189769A
—
MA
05
—
3138968
—
NH
Enumeration date
01/14/2020
Last updated
06/20/2025
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