Active NPI
Deborah Lynn Elsen, RN CDE
- Diabetes Educator Registered Nurse
- Fridley, MN
National Provider Identifier
1295061935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- R 078463-0
- Practice address
- 6401 University Ave NE
#200
Fridley, MN 55432-4341 - Phone
- (763) 586-5883
- Fax
- (763) 571-3088
- NPI assigned
- Oct 31, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | R 078463-0 | MN | Primary |
Addresses
Primary practice location
6401 University Ave NE
#200
Fridley, MN 55432-4341
Mailing address
6401 University Ave NE
#200
Fridley, MN 55432-4341
Phone (763) 586-5883
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 078463-0 | MN | MD | Diabetes Educator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256947200000",
"number": "1295061935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6401 UNIVERSITY AVE NE",
"address_2": "#200",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554324341",
"telephone_number": "763-586-5883",
"fax_number": "763-571-3088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6401 UNIVERSITY AVE NE",
"address_2": "#200",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554324341",
"telephone_number": "763-586-5883",
"fax_number": "763-571-3088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELSEN",
"first_name": "DEBORAH",
"middle_name": "LYNN",
"credential": "RN CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-31",
"last_updated": "2009-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "MN",
"license": "R 078463-0",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fridley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.