Individual provider Active NPI

Kaitlin Elizabeth Buckle, WHNP

  • Women's Health Nurse Practitioner
  • Edina, MN
National Provider Identifier
1386206803
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
9028 Issued in MN
Practice address
6565 France Ave S Ste 400
Edina, MN 55435-2141
Phone
(952) 225-1630
NPI assigned
Jul 4, 2019
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 9028 MN Primary

Addresses

Primary practice location

6565 France Ave S Ste 400
Edina, MN 55435-2141

Mailing address

6565 France Ave S Ste 400
Edina, MN 55435-2141
Phone (952) 225-1630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240705001226 MN Practitioner - Nurse Practitioner 1355775768 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9028MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Minnesota, North Dakota, South Dakota CurrentSince Jun 21, 2024 Accepting new patients
Truecare Urgent Care LLC PastSince Dec 29, 2019 Accepting new patients
CCRM Minneapolis, PC Past Accepting new patients
Burt Faibisoff, MD, PLLC Past Accepting new patients

Locations

671 Vandalia St
Saint Paul, MN 55114
Phone (651) 696-5674

Interoperability endpoints

  • Direct secure messaging: kaitlin.buckle.1@17469.direct.athenahealth.com
  • Direct secure messaging: kaitlin.buckle@335000925634564.direct.elationemr.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1562198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1386206803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 FRANCE AVE S STE 400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352141",
            "telephone_number": "952-225-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 FRANCE AVE S STE 400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352141",
            "telephone_number": "952-225-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLE",
        "first_name": "KAITLIN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-04",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": "9028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.