Marsha Ellen Kaehne, NP-C, RN
Individual provider Active NPI Nurse Practitioner · Cass Lake, MN
NPI 1245669332 · NPPES record last updated Nov 8, 2013
Key facts
- NPI
- 1245669332
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- R 185382-9 (MN)
- Practice address
- 119 Aspen Ave.
Cass Lake, MN 56633 - Phone
- (218) 335-4521
- Fax
- (218) 335-4541
- NPI assigned
- Nov 8, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151207002625 | MN | Order and Referring Only - Nurse Practitioner | 2961702386 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 185382-9 | MN | MD | Gerontology Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R 185382-9 | MN | Yes |
| Adult Health Nurse Practitioner | 363LA2200X | R 185382-9 | MN | |
| Gerontology Nurse Practitioner | 363LG0600X | R 185382-9 | MN |
Addresses
Primary practice location
119 Aspen Ave.
Cass Lake, MN 56633
Mailing address
119 Aspen Ave.
Cass Lake, MN 56633
Phone (218) 335-4521
Other providers in Cass Lake, MN
- Lois Johnson
- Nickalette Johnson
- Tyler Johnson
- Gloria Kathleen Jones
- Karen Marie Jones
- Geoffrey Mark Keilwitz
- Ellie Kosaka
- Jeffrey Krona
- Brandy Kroubetz
- Chad Michael Kumm
All providers in Cass Lake, MN · Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.