Khamal Misra, RN, BSN MSN FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

F03180726 Issued in MN

Practice address

3501 Cranberry Blvd
Weston, WI 54476-5213

Phone

(715) 393-1000

NPI assigned

Oct 8, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1356816201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3052 CATES LN SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559021655",
            "telephone_number": "507-358-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 CRANBERRY BLVD",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765213",
            "telephone_number": "715-393-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISRA",
        "first_name": "KHAMAL",
        "credential": "RN, BSN MSN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "F03180726",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "03180726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan T Mihalus, O.D.
• Deborah Miller, APNP
• Mindful Health Solutions LLC
• Richard Eric Minnihan, M.D.
• Miranda Babl LLC
• Kari Mizgalski, RD, CD
• Joseph M Monaco, MD
• William J Moran, M.D.
• Jessica Lauren Morgan, PTA
• Pajnag Moua, APSW

• Primary Care Nurse Practitioner in Weston, WI
• Providers in Weston, WI by specialty
• Primary Care Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.