Patricia K. Cretilli

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

R 078381 9 Issued in MN

Practice address

5430 Edgewater Blvd
Minneapolis, MN 55417-2604

Phone

(612) 822-2714

NPI assigned

May 24, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cretilli and Associates, PA

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Minneapolis, MN
  • NPI 1376873331
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023229085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 EDGEWATER BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172604",
            "telephone_number": "612-822-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 EDGEWATER BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172604",
            "telephone_number": "612-822-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRETILLI",
        "first_name": "PATRICIA",
        "middle_name": "K.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MN",
            "license": "R 078381 9",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "77D30CR",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Briana McCall Cress
• Vanessa Paulette Cressy, LICSW
• Crestview Assisted Living LLC
• Crestview Residences LLC
• Cretilli and Associates, PA
• Sara Creurer, PSY.D., LP
• Elizabeth Crichton
• Derrick Elton Crim, LADC
• Shannon M Crimmins, LMFT
• Timothy Jesse Crimmins, M.D.

• Adult Psychiatric/Mental Health Registered Nurse in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.