Carolyn Keup Weber, RN, CNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

R0932123 Issued in MN

Practice address

12755 Highway 55
Mn009-S130
Plymouth, MN 55441-3837

Phone

(800) 896-8936

Fax

(888) 866-3209

NPI assigned

Jul 17, 2006

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, Registered Nurse

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285652271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 19TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554472739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12755 HIGHWAY 55",
            "address_2": "MN009-S130",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554413837",
            "telephone_number": "800-896-8936",
            "fax_number": "888-866-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "CAROLYN",
        "middle_name": "KEUP",
        "credential": "RN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R0932123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Scott Watkins, PA
• Wayzata Orthopedic'S P.a.
• Wayzata Orthopedics PA
• Wayzata Public Schools
• Wayzata-Plymouth Meals on Wheels, Inc.
• Mustariha Hassan Webo
• Abigail Webster
• Melissa Weinhandl, LMFT
• Jobi Weinstein, MA LADC
• Lindsay Weisberg

• Gerontology Nurse Practitioner in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.