Active NPI
Lanice Elizabeth Engebretson, RN CNP
- Nurse Practitioner
- Albert Lea, MN
National Provider Identifier
1548240658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R 090896-6
- Practice address
- 404 W Fountain St
Albert Lea, MN 56007-2437 - Phone
- (507) 373-2384
- NPI assigned
- Jan 17, 2006
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R 090896-6 | MN | Primary |
Addresses
Primary practice location
404 W Fountain St
Albert Lea, MN 56007-2437
Mailing address
120 N. Main St
Kiester, MN 56051
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 093042300 | Medicaid | MN |
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)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 090896-6 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Health System-Southeast Minnesota Region | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Durable Medical Equipment & Medical Supplies
- Austin, MN
- NPI 1265462279
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503619200000",
"number": "1548240658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 N. MAIN ST",
"city": "KIESTER",
"state": "MN",
"postal_code": "56051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 W FOUNTAIN ST",
"city": "ALBERT LEA",
"state": "MN",
"postal_code": "560072437",
"telephone_number": "507-373-2384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGEBRETSON",
"first_name": "LANICE",
"middle_name": "ELIZABETH",
"credential": "RN CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-17",
"last_updated": "2017-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "R 090896-6",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "093042300",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albert Lea, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.