Individual
KIRK FJELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1825 CURVE CREST BLVD W STE 103, STILLWATER, MN 55082-6054
(612) 326-7600
(651) 351-0162
Mailing address
550 MAIN ST, NEW BRIGHTON, MN 55112-3271
(612) 326-7600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301765
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871627232
—
MN
Enumeration date
01/03/2019
Last updated
01/03/2019
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