Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

The Minnesota Ketamine and Wellness Institute PA

Organization Anesthesiology Physician · NPI 1003408857

The Minnesota Ketamine and Wellness Institute PA is an Anesthesiology Physician in Maple Grove, Minnesota. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
4
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9325 Upland Ln N Ste 370
Maple Grove, MN 55369-4463
Phone: (612) 394-8717
Fax: (763) 432-5721
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X
Infusion Therapy Clinic/Center Taxonomy 261QI0500X
Adult Mental Health Clinic/Center Taxonomy 261QM0850X
Multi-Specialty Clinic/Center Taxonomy 261QM1300X

Record details

NPI number1003408857
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Christena Hatcher — Cfo · (612) 394-8717
Other names The Minnesota Ketamine And Wellness Institue, P.A.; The Minnesota Ketamine And Wellness Institue, P.A.; The Minnesota And Ketamine Wellness Institute
NPI enumeratedFebruary 3, 2021
Last updated in NPPESAugust 20, 2021
Certification dateAugust 20, 2021
Mailing address9325 Upland Ln N Ste 370, Maple Grove, MN 55369-4463

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