Individual provider Active NPI

Kayla Marie Wiedmann

  • Acute Care Nurse Practitioner
  • Golden Valley, MN
National Provider Identifier
1457268633
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
14645 Issued in MN
Practice address
820 Lilac Dr N Ste 140
Golden Valley, MN 55422-4791
Phone
(763) 465-0500
NPI assigned
Aug 25, 2026
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 14645 MN Primary

Addresses

Primary practice location

820 Lilac Dr N Ste 140
Golden Valley, MN 55422-4791

Mailing address

4954 Airlake Dr
Saint Paul, MN 55129-5730
Phone (651) 387-1914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1787616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1457268633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4954 AIRLAKE DR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551295730",
            "telephone_number": "651-387-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 LILAC DR N STE 140",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224791",
            "telephone_number": "763-465-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDMANN",
        "first_name": "KAYLA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MN",
            "license": "14645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.