Individual provider Active NPI

Kristine Marie Carlson Talley, GNP

  • Gerontology Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1407906522
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R-144891-7 Issued in MN
Practice address
516 Delaware St SE
First Floor PWB, Clinic 1-C
Minneapolis, MN 55455-0356
Phone
(612) 626-3444
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R-144891-7 MN
Gerontology Nurse Practitioner 363LG0600X R-144891-7 MN Primary

Addresses

Primary practice location

516 Delaware St SE
First Floor PWB, Clinic 1-C
Minneapolis, MN 55455-0356

Mailing address

420 Delaware St SE
MMC 395
Minneapolis, MN 55455-0341
Phone (612) 626-3444

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R-144891-7MNMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1407906522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 395",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-626-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 DELAWARE ST SE",
            "address_2": "FIRST FLOOR PWB, CLINIC 1-C",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550356",
            "telephone_number": "612-626-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "KRISTINE",
        "middle_name": "MARIE CARLSON",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R-144891-7",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R-144891-7",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.