Individual provider · Type 1 NPI
Mary Kidder
Nurse Practitioner · St. Paul, MN
Practice location
153 Cesar Chavez St
St. Paul, MN 55107-2226
Fax (651) 602-7517
Mailing address
2601 40th Ave S
Minneapolis, MN 55406-1862
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 113653-3 (MN) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1528020922
Mary Kidder's National Provider Identifier is 1528020922, issued on Apr 3, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in St. Paul, MN. The record was last updated on Jul 13, 2026.