Active NPI
Cindy J Petrie, RN, WOC
- Enterostomal Therapy Registered Nurse
- Eden Prairie, MN
National Provider Identifier
1346404431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Enterostomal Therapy Registered Nurse
- License
- R-169133-7
- Practice address
- 7060 Springhill Cir
Eden Prairie, MN 55346-2615 - Phone
- (952) 993-9632
- NPI assigned
- Jul 17, 2008
- 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 |
|---|---|---|---|---|
| Enterostomal Therapy Registered Nurse | 163WE0900X | R-169133-7 | MN | Primary |
Addresses
Primary practice location
7060 Springhill Cir
Eden Prairie, MN 55346-2615
Mailing address
3057 Patton Rd
Roseville, MN 55113-1042
Phone (651) 428-1820
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-169133-7 | MN | MD | Enterostomal Therapy Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216252800000",
"number": "1346404431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3057 PATTON RD",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551131042",
"telephone_number": "651-428-1820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7060 SPRINGHILL CIR",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553462615",
"telephone_number": "952-993-9632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRIE",
"first_name": "CINDY",
"middle_name": "J",
"credential": "RN, WOC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-17",
"last_updated": "2008-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "163WE0900X",
"taxonomy_group": "",
"desc": "Registered Nurse, Enterostomal Therapy",
"state": "MN",
"license": "R-169133-7",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.