Individual provider Active NPI

Brittany Daniela Tharp

  • Licensed Practical Nurse
  • Lake Elmo, MN
National Provider Identifier
1396677233
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
817850 Issued in MN
Practice address
9640 Hudson Blvd N Unit 1510
Lake Elmo, MN 55042-4521
Phone
(763) 485-3096
NPI assigned
Jun 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 817850 MN Primary

Addresses

Primary practice location

9640 Hudson Blvd N Unit 1510
Lake Elmo, MN 55042-4521

Mailing address

9640 Hudson Blvd N Unit 1510
Lake Elmo, MN 55042-4521
Phone (763) 485-3096

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

State licenses

LicenseStateTypeSpecialty
817850MNMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1396677233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9640 HUDSON BLVD N UNIT 1510",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550424521",
            "telephone_number": "763-485-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9640 HUDSON BLVD N UNIT 1510",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550424521",
            "telephone_number": "763-485-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THARP",
        "first_name": "BRITTANY",
        "middle_name": "DANIELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "817850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elmo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.