Individual provider Active NPI

Angelynn Maire Grabau, MSN RN CNP

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1417999871
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R1368783 Issued in MN
Practice address
2025 E River Parkway
Shriners Hospitals for Children Twin Cities
Minneapolis, MN 55414-3604
Phone
(612) 596-6191
Fax
(612) 339-7634
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R1368783 MN Primary

Addresses

Primary practice location

2025 E River Parkway
Shriners Hospitals for Children Twin Cities
Minneapolis, MN 55414-3604

Mailing address

P.O. Box 209036
Shriners Hospitals for Children Twin Cities
Dallas, TX 75320-9036
Phone (813) 281-8478

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
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R1368783MNMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1417999871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 209036",
            "address_2": "SHRINERS HOSPITALS FOR CHILDREN TWIN CITIES",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753209036",
            "telephone_number": "813-281-8478",
            "fax_number": "813-281-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 E RIVER PARKWAY",
            "address_2": "SHRINERS HOSPITALS FOR CHILDREN TWIN CITIES",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143604",
            "telephone_number": "612-596-6191",
            "fax_number": "612-339-7634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABAU",
        "first_name": "ANGELYNN",
        "middle_name": "MAIRE",
        "credential": "MSN RN CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R1368783",
            "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 Mar 29, 2011; 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.