Active NPI
Carrie Sue Gertsema, RN
- Registered Nurse
- Duluth, MN
National Provider Identifier
1184887879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R 103268-2
- Practice address
- 525 S Lake Ave
Suite 222
Duluth, MN 55802-2362 - Phone
- (218) 740-1198
- NPI assigned
- Jul 3, 2008
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R 103268-2 | MO | Primary |
Addresses
Primary practice location
525 S Lake Ave
Suite 222
Duluth, MN 55802-2362
Mailing address
525 S Lake Ave
Suite 222
Duluth, MN 55802-2362
Phone (218) 740-1198
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
| License | State | Type | Specialty |
|---|---|---|---|
| R 103268-2 | MO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215043200000",
"number": "1184887879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 S LAKE AVE",
"address_2": "SUITE 222",
"city": "DULUTH",
"state": "MN",
"postal_code": "558022362",
"telephone_number": "218-740-1198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 S LAKE AVE",
"address_2": "SUITE 222",
"city": "DULUTH",
"state": "MN",
"postal_code": "558022362",
"telephone_number": "218-740-1198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERTSEMA",
"first_name": "CARRIE",
"middle_name": "SUE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-03",
"last_updated": "2008-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "R 103268-2",
"primary": true
}
],
"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 Jul 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.