Mary Jane Nelson, APRN-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP 1279 Issued in MN

Practice address

705 Pleasant Ave S
Park Rapids, MN 56470-1440

Phone

(218) 732-2800

Fax

(218) 732-2874

NPI assigned

Jan 30, 2007

Last updated

Mar 4, 2016By 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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1417093907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6001",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581086001",
            "telephone_number": "218-732-2800",
            "fax_number": "218-732-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 PLEASANT AVE S",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701440",
            "telephone_number": "218-732-2800",
            "fax_number": "218-732-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MARY",
        "middle_name": "JANE",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP 1279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417093907",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Kay Montzka, D.C.
• Hyacinth Rose Mosse, LSW
• Gladys Marie Murphy
• Jeremy John Nelson, D.C.
• Lora Lynne Nelson, D.D.S.
• Kathryn L Nevins, CNP
• Nisene Dialysis, LLC (Park Rapids Dialysis)
• Michelle Marie Noffze, LPCC
• Brenda J Norby, P.A-C
• North Country Medicine LLC

• Family Nurse Practitioner in Park Rapids, MN
• Providers in Park Rapids, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; 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.