Active NPI
Judith A Wulf, ANP
- Nurse Practitioner
- St. Paul, MN
National Provider Identifier
1184698557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- CNP2302
- Practice address
- 401 Phalen Boulevard
St. Paul, MN 55130-5302 - Phone
- (651) 254-7900
- Fax
- (651) 254-7904
- NPI assigned
- Feb 14, 2006
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | CNP2302 | MN | Primary |
Addresses
Primary practice location
401 Phalen Boulevard
St. Paul, MN 55130-5302
Mailing address
PO Box 1309 - 8170 33Rd Ave S
Mail Stop 21110Q
Minneapolis, MN 55425-4516
Phone (651) 254-7900
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04-10205 | Other | MN | MEDICA |
| 1184698557 | Medicaid | MN | |
| 43917100 | Medicaid | WI |
Other names 1
- Judith A Greenwood
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP2302 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nura PLLC | 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.
-
- Pain Medicine Physician
- Minneapolis, MN
- NPI 1750316014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443657600000",
"number": "1184698557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1309 - 8170 33RD AVE S",
"address_2": "MAIL STOP 21110Q",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554254516",
"telephone_number": "651-254-7900",
"fax_number": "651-254-7904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 PHALEN BOULEVARD",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "551305302",
"telephone_number": "651-254-7900",
"fax_number": "651-254-7904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WULF",
"first_name": "JUDITH",
"middle_name": "A",
"credential": "ANP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-14",
"last_updated": "2015-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "CNP2302",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "04-10205",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1184698557",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43917100",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JUDITH",
"last_name": "GREENWOOD",
"middle_name": "A",
"code": "5",
"type": "Other Name"
}
]
}Other providers in St. Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.