Active NPI
Joan Mielke
- Plastic Surgery Registered Nurse
- St Louis Park, MN
National Provider Identifier
1467439539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Registered Nurse
- License
- R1238936
- Practice address
- 3900 Park Nicollet Blvd
St Louis Park, MN 55416-2503 - Phone
- (952) 993-3504
- NPI assigned
- Dec 29, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Registered Nurse | 163WS0121X | R1238936 | MN | Primary |
Addresses
Primary practice location
3900 Park Nicollet Blvd
St Louis Park, MN 55416-2503
Mailing address
6465 Wayzata Blvd
Suite 315
St Louis Park, MN 55426-1728
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1238936 | MN | MD | Plastic Surgery Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1467439539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6465 WAYZATA BLVD",
"address_2": "SUITE 315",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554261728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 PARK NICOLLET BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554162503",
"telephone_number": "952-993-3504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIELKE",
"first_name": "JOAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-29",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0121X",
"taxonomy_group": "",
"desc": "Registered Nurse, Plastic Surgery",
"state": "MN",
"license": "R1238936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.