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

Kaitlen Gullicksrud, ATC/R

Individual provider Athletic Trainer · NPI 1841649290

Kaitlen Gullicksrud, ATC/R is an Athletic Trainer in Roseville, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2016

Practice location Address checks out

1151 Transit Ave
Roseville, MN 55113-3233
Phone: (715) 379-0408
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2325 (MN)

Record details

NPI number1841649290
Entity typeIndividual (Type 1)
GenderFemale
Credentials ATC/R
Sole proprietorYes
NPI enumeratedJune 7, 2016
Last updated in NPPESJune 7, 2016

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