Jacklyn Holmberg, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1690 Issued in MN

Practice address

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926

Phone

(763) 520-5200

Fax

(763) 581-0993

NPI assigned

Aug 25, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Anesthesia Providers LLCGroup PAC ID 7315986064, 325 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• University Anesthesia Providers, LLC

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1699711143

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Anesthesiology, P.a.

  • Anesthesiology Physician
  • Robbinsdale, MN
  • NPI 1013960798

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212
  Care Compare affiliation
• Fairview Health Services

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1316347602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-520-5200",
            "fax_number": "763-581-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-520-5200",
            "fax_number": "763-581-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMBERG",
        "first_name": "JACKLYN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-25",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R188489-8",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "1690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystal Hoang, DDS
• Sandra M Hodgkin, RN, CNP
• Marcia A Hoffman, GNP
• Jessica Hoffmann
• Barrett Holen, M.D.
• Mary Marrs Holmes, LSW
• Katelyn Holmquist, DNP, APRN, CNP
• Daniel R Holt, PHARMD, RPH
• Emily Elise Honl
• Natalie Faith Hood, MD

• Certified Registered Nurse Anesthetist in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.