Kelsi Gruber Kellerhuis

Individual provider Active NPI Registered Nurse · Circle Pines, MN

NPI 1083569099 · NPPES record last updated Mar 4, 2026

Key facts

NPI
1083569099
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
2485056 (MN)
Practice address
4707 North Rd
Circle Pines, MN 55014-1545
Phone
(763) 792-6000
NPI assigned
Mar 4, 2026
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2485056MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial School District Past
since Nov 24, 2025
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2485056 MN Yes

Addresses

Primary practice location

4707 North Rd
Circle Pines, MN 55014-1545

Mailing address

4707 North Rd
Circle Pines, MN 55014-1545

Other providers in Circle Pines, MN

All providers in Circle Pines, MN · Registered Nurse in Minnesota

Sources for this page

Verify at the official NPI Registry.