Provider Demographics
NPI:1144517509
Name:EDMONSON, KAREN ELIZABETH (DPT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ELIZABETH
Last Name:EDMONSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ELIZABETH
Other - Last Name:HANADEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4200 DAHLBERG DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4840
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:952-512-5651
Practice Address - Street 1:3111 124TH AVE NW
Practice Address - Street 2:SUITE 200
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-4572
Practice Address - Country:US
Practice Address - Phone:763-427-7300
Practice Address - Fax:763-427-2802
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9384174400000X
MN92612251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No174400000XOther Service ProvidersSpecialist