NPIMap

Individual provider Active NPI

Kristina Anne Haden, APRN, CNP

  • Family Nurse Practitioner
  • Grand Rapids, MN
National Provider Identifier
1578290698
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9678 Issued in MN
Practice address
1542 Golf Course Rd
Grand Rapids, MN 55744-3555
Phone
(218) 999-7000
NPI assigned
Aug 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9678 MN Primary

Addresses

Primary practice location

1542 Golf Course Rd
Grand Rapids, MN 55744-3555

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221125000532 MN Practitioner - Nurse Practitioner 2062880925 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, shared by 25 NPIs, 1,135 clinicians

Practice addresses (Care Compare)

1542 Golf Course Rd
Suite 204
Grand Rapids, MN 55744-3537
Phone (218) 999-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9678MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Pines Orthopaedic Clinic, P.a. CurrentSince Aug 14, 2022 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Nov 7, 2022 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Deer River Healthcare Center, Inc. Current Accepting new patients
Deer River Healthcare Center, Inc CurrentSince Nov 7, 2022 Accepting new patients
Deer River Healthcare Center, Inc. CurrentSince Nov 7, 2022 Accepting new patients
The Duluth Clinic LTD CurrentSince Nov 7, 2022 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

115 10th Ave NE
Deer River, MN 56636
Phone (218) 246-2900

115 10th Ave NE
#A
Deer River, MN 56636
Phone (218) 246-8275

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

1542 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3937

1542 Golf Course Rd
Ste 204
Grand Rapids, MN 55744
Phone (218) 322-4900

Organizations & group practices 8

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1578290698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 GOLF COURSE RD",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443555",
            "telephone_number": "218-999-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADEN",
        "first_name": "KRISTINA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "9678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

Verify at the official NPI Registry.