Provider Demographics
NPI:1447059332
Name:MAMA KJ CARE, INC
Entity type:Organization
Organization Name:MAMA KJ CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:KIELAS-JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-942-5676
Mailing Address - Street 1:7900 INTERNATIONAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-2562
Mailing Address - Country:US
Mailing Address - Phone:952-942-5676
Mailing Address - Fax:
Practice Address - Street 1:7900 INTERNATIONAL DRIVE
Practice Address - Street 2:SUITE 300 OFFICE 353
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-5542
Practice Address - Country:US
Practice Address - Phone:952-942-5676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty