Provider Demographics
NPI:1972206639
Name:BRATT, KIRSTIN RUTH
Entity type:Individual
Prefix:DR
First Name:KIRSTIN
Middle Name:RUTH
Last Name:BRATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3611
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-0611
Mailing Address - Country:US
Mailing Address - Phone:612-888-6392
Mailing Address - Fax:
Practice Address - Street 1:1806 IRVING AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-3155
Practice Address - Country:US
Practice Address - Phone:612-888-6392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide