Nicoli Franklin Bettin, APRN, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Duluth, MN
NPI 1104581586 · NPPES record last updated Jan 15, 2025
Key facts
- NPI
- 1104581586
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 2859 (MN)
- Practice address
- 400 E 3Rd St
Duluth, MN 55805-1951 - Phone
- (218) 786-8364
- NPI assigned
- Nov 1, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 36
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Duluth Clinic LTD
Practice addresses (Care Compare)
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
Hospital & facility affiliations
- Essentia Health St Mary'S Medical Center
- Essentia Health Duluth
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in WI, MA, MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220623002052 | WI | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6305225202 | Reassigns benefits to 4 organizations |
| I20220929000165 | MA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6305225202 | Reassigns benefits to 2 organizations |
| I20240820003043 | MN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6305225202 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 231479-30 | WI | MD | Registered Nurse |
| 2859 | MN | MD | Certified Registered Nurse Anesthetist |
| 231479 | WI | MD | Certified Registered Nurse Anesthetist |
Practice roles
Locations
55 Fruit St
Boston, MA 02114
55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000
733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806
1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311
700 West Ave S
La Crosse, WI 54601
Phone (608) 791-4156
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 231479-30 | WI | |
| Certified Registered Nurse Anesthetist | 367500000X | 231479 | WI | |
| Certified Registered Nurse Anesthetist | 367500000X | 2859 | MN | Yes |
Addresses
Primary practice location
400 E 3Rd St
Duluth, MN 55805-1951
Mailing address
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
Other practice location 1
1400 Bellinger St
Eau Claire, WI 54703-5222
Phone (715) 838-5222
NPI Registry JSON
{
"created_epoch": "1635724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736899200000",
"number": "1104581586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E 3RD ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051951",
"telephone_number": "218-786-8364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E 3RD ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051951",
"telephone_number": "218-786-8364"
}
],
"practiceLocations": [
{
"address_1": "1400 Bellinger St",
"address_purpose": "LOCATION",
"city": "Eau Claire",
"state": "WI",
"postal_code": "547035222",
"country_code": "US",
"telephone_number": "715-838-5222",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BETTIN",
"first_name": "NICOLI",
"middle_name": "FRANKLIN",
"name_prefix": "Mr.",
"credential": "APRN, CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-01",
"last_updated": "2025-01-15",
"certification_date": "2025-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "231479-30",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WI",
"license": "231479",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "2859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
- Shana Marie Bertin
- Kathryn Louise Bertz
- Erin Elizabeth Beste
- Bonnie Jean Besvold
- Joseph Bettendorf
- Jillene Beuke
- Sydney Hope Bexell
- Christine A Beyer
- Jonathan McKay Beyer
- Laurie Jane Beyer
All providers in Duluth, MN · Certified Registered Nurse Anesthetist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.