Individual provider Active NPI

Judy Lynn Nelson, APRN, CNP

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1104012145
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
104299142 Issued in MN
Practice address
715 South 8TH Street
HCMC Clinic and Specialty Center
Minneapolis, MN 55404-1210
Phone
(651) 230-3181
NPI assigned
Sep 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R 103753-5 MN
Nurse Practitioner 363L00000X 104299142 MN Primary

Addresses

Primary practice location

715 South 8TH Street
HCMC Clinic and Specialty Center
Minneapolis, MN 55404-1210

Mailing address

2275 Youngman Avenue
#508W
St Paul, MN 55116-4409
Phone (651) 230-3181

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
104299142MNMDNurse Practitioner
R 103753-5MNMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Tree Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1104012145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 YOUNGMAN AVENUE",
            "address_2": "#508W",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551164409",
            "telephone_number": "651-230-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 SOUTH 8TH STREET",
            "address_2": "HCMC CLINIC AND SPECIALTY CENTER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554041210",
            "telephone_number": "651-230-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JUDY",
        "middle_name": "LYNN",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": "R 103753-5",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "104299142",
            "primary": true
        }
    ],
    "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 Apr 5, 2021; 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.