Individual provider Active NPI

Donna Jean Amidon, CNP

  • Registered Nurse
  • Minneapolis, MN
National Provider Identifier
1043388192
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R0634023 Issued in MN
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

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
R0634023MNMDRegistered Nurse
82001MNMDPediatric 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.

Verify at the official NPI Registry.