Provider Demographics
NPI:1427522432
Name:SCHOEN, KAI M
Entity type:Individual
Prefix:
First Name:KAI
Middle Name:M
Last Name:SCHOEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2096 FAIRWAYS LN
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-3813
Mailing Address - Country:US
Mailing Address - Phone:651-757-7408
Mailing Address - Fax:
Practice Address - Street 1:2096 FAIRWAYS LN
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-3813
Practice Address - Country:US
Practice Address - Phone:651-757-7408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program