Individual provider Active NPI

Christine Mazanec, RN

  • Medical-Surgical Registered Nurse
  • Burnsville, MN
National Provider Identifier
1427575166
Registry record updated Aug 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
R130202-4 Issued in MN
Practice address
3424 W Park Dr
Burnsville, MN 55306-6981
Phone
(612) 802-4210
NPI assigned
Aug 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X R130202-4 MN Primary

Addresses

Primary practice location

3424 W Park Dr
Burnsville, MN 55306-6981

Mailing address

3424 W Park Dr
Burnsville, MN 55306-6981
Phone (612) 802-4210

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R130202-4MNMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503532800000",
    "number": "1427575166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 W PARK DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553066981",
            "telephone_number": "612-802-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 W PARK DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553066981",
            "telephone_number": "612-802-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZANEC",
        "first_name": "CHRISTINE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2017-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MN",
            "license": "R130202-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; 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.