Kristie J Anderson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R1202823 Issued in MN

Practice address

6905 York Ave S
Edina, MN 55424

Phone

(866) 389-2727

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 18, 2021.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1215095435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5548 THOMAS AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102544",
            "telephone_number": "612-226-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 YORK AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55424",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "671 Vandalia St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551141312",
            "country_code": "US",
            "telephone_number": "651-696-5511",
            "fax_number": "651-696-5553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KRISTIE",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R1202823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey P Anderson, D.C., D.A.B.C.I.
• John Theodore Anderson, M.D.
• Karen Lou Anderson, LICSW
• Katie Maryl Anderson, CNP
• Kelly Lynn Anderson, MASSAGE THERAPIST
• Madisyn E Anderson, OTR/L
• Mark Omar Anderson, M.S.
• Michael Joseph Anderson, MD
• Richard J Anderson, D.D.S.
• Stephanie Leigh Anderson, MD

• All providers in Edina, MN
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.