Egle Otto

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP4739 Issued in MN

Practice address

1900 Silver Lake Rd NW Ste 110
Nystrom & Associates
New Brighton, MN 55112-1789

Phone

(651) 746-2392

NPI assigned

Aug 30, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1487100384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "address_2": "NYSTROM & ASSOCIATES",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-746-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "address_2": "NYSTROM & ASSOCIATES",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-746-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "EGLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "CNP4739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oral & Maxillofacial Surgery Specialists, PA
• Christine Osgood, LMFT
• Elizabeth Ostby, MA
• Meghan Osterbauer, LMFT
• Otter Tail Health Care Services LLC
• Lee James Panzer, PT
• Kim Contardi Pareigat, MA LP
• Sarah Elizabeth Parker, LMFT
• Parkside Dental, P.C.
• Thomas Pastor IV, D.C.

• Psychiatric/Mental Health Nurse Practitioner in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.