Individual provider Active NPI

Jaclyn Rose Guetzko, DNP, APRN, CNP

  • Adult Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1275914020
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
CNP3931 Issued in MN
Practice address
3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761
Phone
(763) 587-7737
NPI assigned
Jun 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X CNP3931 MN
Adult Health Nurse Practitioner 363LA2200X CNP3931 MN Primary

Addresses

Primary practice location

3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761

Mailing address

3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761
Phone (763) 587-7737

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
I20150724011528 MN Practitioner - Nurse Practitioner 6507179132 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geriatric Services of Minnesota LLCGroup PAC ID 2365667557, 44 clinicians
Genevive Aco LLCGroup PAC ID 8628585080, 43 clinicians

Practice addresses (Care Compare)

3433 Broadway St NE
Suite 300
Minneapolis, MN 55413-1761
Phone (763) 587-7737

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP3931MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Services of Minnesota, LLC CurrentSince Mar 24, 2025 Accepting new patients
Genevive Aco LLC CurrentSince Sep 1, 2025 Accepting new patients
Allina Health System CurrentSince Sep 14, 2015 Accepting new patients
Allina Health System Current Accepting new patients
Lifespark Medical Group, PA Adult Health CurrentSince Jan 1, 2023 Accepting new patients
Allina Health System CurrentSince Sep 14, 2015 Accepting new patients

Locations

715 1st St N
Cold Spring, MN 56320
Phone (320) 685-3693

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

7920 Old Cedar Ave S
Minneapolis, MN 55425
Phone (952) 428-1800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

3433 Broadway St NE
Ste 300
Minneapolis, MN 55413

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

5320 W 23rd St
Ste 130
St Louis Park, MN 55416
Phone (952) 345-3213

Organizations & group practices 6

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1275914020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131761",
            "telephone_number": "763-587-7737",
            "fax_number": "651-383-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131761",
            "telephone_number": "763-587-7737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUETZKO",
        "first_name": "JACLYN",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "CNP3931",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "CNP3931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.