Active NPI
Kylie Aanerud
- Behavior Analyst
- Plymouth, MN
National Provider Identifier
1124646625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-22-63211
- Practice address
- 3007 Harbor LN N
Plymouth, MN 55447-5103 - Phone
- (507) 322-7752
- NPI assigned
- Jul 10, 2020
- Last updated
- Dec 22, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-22-63211 | MN | Primary |
Addresses
Primary practice location
3007 Harbor LN N
Plymouth, MN 55447-5103
Mailing address
3010 Sumter Ave N Apt 11
Crystal, MN 55427-2851
Phone (763) 291-1775
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671667200000",
"number": "1124646625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 SUMTER AVE N APT 11",
"city": "CRYSTAL",
"state": "MN",
"postal_code": "554272851",
"telephone_number": "763-291-1775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3007 HARBOR LN N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554475103",
"telephone_number": "507-322-7752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AANERUD",
"first_name": "KYLIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-10",
"last_updated": "2022-12-22",
"certification_date": "2022-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MN",
"license": "1-22-63211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.