Individual provider · Type 1 NPI

Marisa Keidel, NP

Gerontology Nurse Practitioner · Coon Rapids, MN

NPI number 1609741693 Active

Practice location

4040 Coon Rapids Blvd NW Ste 120
Coon Rapids, MN 55433-4568

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600X13022 (MN)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1609741693

Marisa Keidel, NP's National Provider Identifier is 1609741693, issued on Oct 8, 2025. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Coon Rapids, MN. The record was last updated on Feb 26, 2026.