Individual provider Active NPI

Krystal Siegle, R.N.

  • Home Health Registered Nurse
  • Duluth, MN
National Provider Identifier
1184020125
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
222867-3 Issued in MN
Practice address
4815 Burning Tree Rd
Duluth, MN 55811-3800
Phone
(218) 733-0707
NPI assigned
Nov 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 222867-3 MN Primary
Home Health Registered Nurse 163WH0200X 000000000219781 WI

Addresses

Primary practice location

4815 Burning Tree Rd
Duluth, MN 55811-3800

Mailing address

4815 Burning Tree Rd
Duluth, MN 55811-3800
Phone (218) 733-0707

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
222867-3MNMDHome Health Registered Nurse
000000000219781WIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1184020125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 BURNING TREE RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558113800",
            "telephone_number": "218-733-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 BURNING TREE RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558113800",
            "telephone_number": "218-733-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGLE",
        "first_name": "KRYSTAL",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "222867-3",
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "000000000219781",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.