Active NPI
Donna Jean Amidon, CNP
- Registered Nurse
- Minneapolis, MN
National Provider Identifier
1043388192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R0634023
- Practice address
- 250 So 4TH St Room 510
MPLS Dept of Health & Family Support School Based Clin
Minneapolis, MN 55415 - Phone
- (612) 673-5305
- Fax
- (612) 673-3866
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R0634023 | MN | Primary |
| Pediatric Nurse Practitioner | 363LP0200X | 82001 | MN |
Addresses
Primary practice location
250 So 4TH St Room 510
MPLS Dept of Health & Family Support School Based Clin
Minneapolis, MN 55415
Mailing address
308 Parkway Court
Minneapolis, MN 55419
Phone (612) 824-5401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0634023 | MN | MD | Registered Nurse |
| 82001 | MN | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1043388192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 PARKWAY COURT",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55419",
"telephone_number": "612-824-5401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 SO 4TH ST ROOM 510",
"address_2": "MPLS DEPT OF HEALTH & FAMILY SUPPORT SCHOOL BASED CLIN",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55415",
"telephone_number": "612-673-5305",
"fax_number": "612-673-3866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMIDON",
"first_name": "DONNA",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "R0634023",
"primary": true
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MN",
"license": "82001",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.