Kathleen Riley Goedel, NP

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R049321-9 Issued in MN

Practice address

1010 4TH St
Two Harbors, MN 55616-1200

Phone

(218) 834-7200

Fax

(218) 834-7220

NPI assigned

Jul 5, 2006

Last updated

Mar 17, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kathleen Riley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1386675916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 4TH ST",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556161200",
            "telephone_number": "218-834-7200",
            "fax_number": "218-834-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 4TH ST",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556161200",
            "telephone_number": "218-834-7200",
            "fax_number": "218-834-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEDEL",
        "first_name": "KATHLEEN",
        "middle_name": "RILEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R049321-9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "RILEY",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Timothy Carl Erickson, DDS
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• Joan Michelle Gelineau, RN
• Jamie Ann Grajewski
• Dorey May Hage
• Michelle B Hallman, PHARMACY TECHNICIAN
• Eric Tolga Hanhan, MD
• Alyssa J Hastings, RPH, PHARMD

• Registered Nurse in Two Harbors, MN
• Providers in Two Harbors, MN by specialty
• Registered Nurse in Minnesota

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

Verify at the official NPI Registry.