KELLY JEAN PERRAULT (NPI# 1437392040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437392040 |
| Entity Type | Individual |
| Full Name | KELLY JEAN PERRAULT |
| Credential | PA-C |
| Practice Address |
6500 Excelsior Blvd Heart and Vascular Center, 1st Floor St Louis Park MN 55426-4702 |
| Mailing Address |
6500 Excelsior Blvd St Louis Park MN 55426-4702 |
| Practice Telephone | 6514923064 |
| Mailing Telephone | 6514923064 |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2011-07-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1256 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6500 EXCELSIOR BLVD HEART AND VASCULAR CENTER, 1ST FLOOR |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55426-4702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861484669 | Robert E Haselow | Radiology | 6500 Excelsior Blvd, Methodist Radiation Therapy, St Louis Park, MN 55426-4702 | 2005-08-17 |
| 1215549381 | Katelyn Boys | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-08-20 |
| 1386253466 | Christine Harlander | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2020-07-24 |
| 1063021210 | Ian-thomas Campbell-groen | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2020-07-23 |
| 1619585387 | Kelly Faber | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-07-20 |
| 1952938821 | Paige Rygg | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-03-23 |
| 1801427406 | Brandi Jo St. Mane | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-02-01 |
| 1811528680 | Brian Servey IIi | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-01-30 |
| 1245873421 | Weston Poucher | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2019-10-21 |
| 1427609973 | Lauren Damrow | Registered Nurse | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2019-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657545 | Big Brain Concussion Recovery & Chiropractic Pa | Chiropractor | 3313 Republic Ave., St. Louis Park, MN 55426 | 2019-06-06 |
| 1912485095 | Daniel Raies | Optometrist | 8900 Minnesota 7, St Louis Park, MN 55426 | 2018-08-01 |
| 1649756040 | Wayside House, Inc. | Clinic/Center | 1349 Jersey Ave S, St. Louis Park, MN 55426 | 2018-07-18 |
| 1104302884 | Superior Caregivers, LLC | In Home Supportive Care | 1319 Lancaster Ave., St. Louis Park, MN 55426 | 2018-07-16 |
| 1396234266 | Caitlin Kwiatkowski | Behavior Technician | 7010 Mn-7, St.louis Park, MN 55426 | 2018-05-07 |
| 1497244313 | Kelly Ann Clancey | Behavior Technician | 7010 Highway 2, Saint Louis Park, MN 55426 | 2018-05-07 |
| 1770072696 | Ashleigh Hakala | Behavior Technician | 7010 Highway 7 St. Louis Park Mn 55426, St. Louis Park, MN 55426 | 2018-05-07 |
| 1689181521 | Glenda Miles | Registered Nurse | 7316 Cedar Lake Road, Apt 8, St Louis Park, MN 55426 | 2017-12-31 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1447775549 | Belinda Sue Bliss | Marriage & Family Therapist | 3301 Decatur Lane, Saint Louis Park, MN 55426 | 2017-08-09 |
| Find all providers in zip 55426 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538545686 | Kathryn Jelle | Physician Assistant | 3931 Louisiana Ave S # 55426, St Louis Park, MN 55426-5000 | 2015-07-30 |
| 1245862846 | Caara Hirsch Leintz | Physician Assistant | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2020-02-11 |
| 1073091039 | Casey Lynne Malenstyn | Physician Assistant | 3800 Park Nicollet Blvd, St Louis Park, MN 55416 | 2018-08-01 |
| 1669984274 | Auguste C Wolle | Physician Assistant | 6600 Excelsior Blvd, St Louis Park, MN 55426 | 2017-11-05 |
| 1437670866 | Becky Philipsek | Physician Assistant | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2017-07-06 |
| 1144692765 | Chelsea Finger | Physician Assistant | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2015-10-22 |
| 1255739942 | Samantha Elizabeth Eklund | Physician Assistant | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2014-12-11 |
| 1477990166 | Emily Spangler | Physician Assistant | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2013-06-04 |
| 1730311887 | Erik L. Haltson | Physician Assistant | 5100 Gamble Dr, Suite 100, St Louis Park, MN 55416-1521 | 2009-08-21 |
| 1174752422 | Linda Shaw Haller | Physician Assistant | 4201 Excelsior Blvd, St Louis Park, MN 55416-4728 | 2009-07-08 |
| Find all providers in ST LOUIS PARK | ||||
| City | ST LOUIS PARK |
| Zip Code | 55426 |
Please comment or provide details below to improve the information on KELLY JEAN PERRAULT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.