Individual
KRISTIN K MELLGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
161 19TH ST S STE 106, SARTELL, MN 56377-2555
(320) 252-3376
(320) 288-2701
Mailing address
161 19TH ST S STE 106, SARTELL, MN 56377-2555
(320) 252-3376
(320) 288-2701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9855
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
970001852
—
MN
Enumeration date
07/02/2006
Last updated
09/05/2025
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