Nicole Marie Jenabzadeh, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F05111030 Issued in MN

Practice address

130 Cheshire LN Ste 100
Minnetonka, MN 55305-0002

Phone

(952) 807-0415

Fax

(952) 236-6461

NPI assigned

Jun 30, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, 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.

• Medstudio, PLLC

  • General Practice Physician
  • Minnetonka, MN
  • NPI 1336677483
  NPD (past)

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1215224092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550250308",
            "telephone_number": "952-807-0415",
            "fax_number": "952-236-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CHESHIRE LN STE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553050002",
            "telephone_number": "952-807-0415",
            "fax_number": "952-236-6461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7591 9th St N Ste 100",
            "address_purpose": "LOCATION",
            "city": "Oakdale",
            "state": "MN",
            "postal_code": "551286626",
            "country_code": "US",
            "telephone_number": "952-807-0415",
            "fax_number": "952-236-6461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENABZADEH",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "F05111030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Margaret Janke, NP
• Madeline Anastasia Janke, PA-C
• Colleen Kay O'Brien Janssen, M.S., CCC-SLP
• Jeana Lee Jarvis, ARNP
• Elizabeth Anne Javinsky, MA, LP
• Kellan Matthews Jenkins, LPC
• Alison Jensen
• Mark Robert Jensen, DDS
• Jacqueline Allen Jessie, FNP
• Theodore Thomas Jewett, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.