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
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 13022 (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.