Provider Demographics
NPI:1902697097
Name:SCHREIBER, KATIANNA NICOLE
Entity type:Individual
Prefix:
First Name:KATIANNA
Middle Name:NICOLE
Last Name:SCHREIBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATIANNA
Other - Middle Name:NICOLE
Other - Last Name:HILLERUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1960 5TH ST NW
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-6545
Mailing Address - Country:US
Mailing Address - Phone:612-490-1383
Mailing Address - Fax:
Practice Address - Street 1:1517 HIGHWAY 13 E
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-2917
Practice Address - Country:US
Practice Address - Phone:612-756-9107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician