Individual provider Active NPI

Carolyn Sue Oeltjenbruns, CNP

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1215992771
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
270 Issued in MN
Practice address
410 Church St SE
Minneapolis, MN 55455-0222
Phone
(612) 625-8400
Fax
(612) 677-3211
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 270 MN Primary

Addresses

Primary practice location

410 Church St SE
Minneapolis, MN 55455-0222

Mailing address

410 Church St SE
Minneapolis, MN 55455-0222
Phone (612) 625-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040316000916 MN Practitioner - Nurse Practitioner 9830089762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

410 Church St SE
Minneapolis, MN 55455-0222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
270MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince May 25, 2019 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince May 25, 2019 Accepting new patients
Regents of the University of Minnesota CurrentSince Jun 5, 2023 Accepting new patients
Regents of the University of Minnesota CurrentSince Jun 5, 2023 Accepting new patients
Regents of the University of Minnesota Current Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

410 Church St SE
#W235
Minneapolis, MN 55455

3033 Excelsior Blvd
Ste 275
Minneapolis, MN 55416
Phone (612) 827-4751

410 Church St SE
Minneapolis, MN 55455
Phone (612) 625-8400

701 25th Ave S
Ste 402
Minneapolis, MN 55454
Phone (612) 672-2900

3809 42nd Ave S
Minneapolis, MN 55406
Phone (612) 407-7213

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

2155 Ford Pkwy
Ste A
Saint Paul, MN 55116
Phone (651) 696-5000

1151 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (612) 706-4500

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1215992771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CHURCH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550222",
            "telephone_number": "612-625-8400",
            "fax_number": "612-677-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CHURCH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550222",
            "telephone_number": "612-625-8400",
            "fax_number": "612-677-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OELTJENBRUNS",
        "first_name": "CAROLYN",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.