Connie Semmelroth, RN, CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R147667-5 Issued in MN

Practice address

332 W Superior St
Suite 300
Duluth, MN 55802-1808

Phone

(218) 722-4379

Fax

(218) 722-4333

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Connie Rae Melanson/Cardinal Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1265513998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 W SUPERIOR ST",
            "address_2": "SUITE 300",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021808",
            "telephone_number": "218-722-4379",
            "fax_number": "218-722-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMMELROTH",
        "first_name": "CONNIE",
        "credential": "RN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R147667-5",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "725269200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "MELANSON/CARDINAL",
            "middle_name": "RAE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Benjamin Gregory Selle, DO
• Jessica M Selle, D.O.
• Kelsey Ann Sellnow, PA-C
• Nathan David Selstad, APRN, CNP
• Maggie Sem, MD
• Debbie Rae Semmelroth, DNP, MSW, LICSW
• Brianna Hope Senger, PA-C
• Christopher Dean Senger, PA-C
• Elizabeth Sengstock
• Courtney Erin Senich

• Psychiatric/Mental Health Nurse Practitioner in Duluth, MN
• Providers in Duluth, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.