Individual provider Active NPI

Kelsey Lynn Wyrd, CNP

  • Nurse Practitioner
  • St Louis Park, MN
National Provider Identifier
1376356642
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
12278 Issued in MN
Practice address
3504 Wyoming Ave S
St Louis Park, MN 55426-3824
Phone
(262) 327-3419
NPI assigned
Jan 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 12278 MN Primary

Addresses

Primary practice location

3504 Wyoming Ave S
St Louis Park, MN 55426-3824

Mailing address

3504 Wyoming Ave S
St Louis Park, MN 55426-3824
Phone (262) 327-3419

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
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12278MNMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1376356642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3504 WYOMING AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263824",
            "telephone_number": "262-327-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 WYOMING AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263824",
            "telephone_number": "262-327-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYRD",
        "first_name": "KELSEY",
        "middle_name": "LYNN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "12278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.