Individual provider Active NPI

Kiersten Suzanne Nolan, CNP

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1568226314
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
11281 Issued in MN
Practice address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone
(952) 992-5290
NPI assigned
Feb 12, 2024
Last updated
Aug 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 11281 MN Primary

Addresses

Primary practice location

2525 Chicago Ave
Minneapolis, MN 55404-4518

Mailing address

2525 Chicago Ave
Minneapolis, MN 55404-4518

Other practice location 1

500 S Maple St
Waconia, MN 55387-1752
Phone (952) 442-2191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240503003352 MN Practitioner - Nurse Practitioner 3577903715 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11281MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Medical Center Current Accepting new patients
Ridgeview Medical Center CurrentSince Mar 25, 2024 Accepting new patients
Children's Health Care CurrentSince Nov 3, 2025 Accepting new patients
Ridgeview Medical Center CurrentSince Mar 25, 2024 Accepting new patients
Childrens Health Care CurrentSince Nov 3, 2025 Accepting new patients
Childrens Health Care Current Accepting new patients
Ridgeview Medical Center Past Accepting new patients

Locations

165 W Commerce Dr
Belle Plaine, MN 56011
Phone (952) 777-5661

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

916 Saint Peter Ave E
Delano, MN 55328
Phone (763) 972-9172

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1568226314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "952-992-5290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 S Maple St",
            "address_purpose": "LOCATION",
            "city": "Waconia",
            "state": "MN",
            "postal_code": "553871752",
            "country_code": "US",
            "telephone_number": "952-442-2191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "KIERSTEN",
        "middle_name": "SUZANNE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "11281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.