Natalie Jane Gustafson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP0497 Issued in MN

Practice address

1542 Golf Course Rd Ste 204
Grand Rapids, MN 55744-3555

Phone

(218) 999-7000

NPI assigned

Aug 15, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Northern Itasca Hospital District

  • Critical Access Hospital
  • Bigfork, MN
  • NPI 1851335525
  Medicare reassignment NPD
• Deer River Healthcare Center, Inc.

  • Critical Access Hospital
  • Deer River, MN
  • NPI 1225049018
  NPD (past)

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1144578568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 5TH ST SE",
            "city": "COOK",
            "state": "MN",
            "postal_code": "557239702",
            "telephone_number": "218-666-5941",
            "fax_number": "218-666-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 GOLF COURSE RD STE 204",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443555",
            "telephone_number": "218-999-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "NATALIE",
        "middle_name": "JANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R178810-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP0497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guardian Flight LLC
• Cristina Inez McLean Guimaraes, PHARMD
• Angela M Gunderson, OTR/L
• Gunnerson Chiropractic Inc.
• Lane N Gunnerson, DC
• Bruce Haag, LADC
• Theresa Louise Hachey, LADC
• Kristina Anne Haden, APRN, CNP
• Lindsey Hagen, LADC
• Michael Theodore Hagley, DDS

• Family Nurse Practitioner in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.