Individual provider Active NPI

Debra C. Zinken, MA, RN, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rogers, MN
National Provider Identifier
1588700702
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R101756-8 Issued in MN
Practice address
21370 John Milless Dr
Suite #210
Rogers, MN 55374-9449
Phone
(763) 428-2288
Fax
(763) 428-2132
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R101756-8 MN Primary

Addresses

Primary practice location

21370 John Milless Dr
Suite #210
Rogers, MN 55374-9449

Mailing address

21370 John Milless Dr
Suite #210
Rogers, MN 55374-9449
Phone (763) 428-2288

Other names 1

  • Miss Debra C Christianson Former name

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
I20100121000710 MN Practitioner - Nurse Practitioner 2365584877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Horizon Psychiatry LLCGroup PAC ID 7214214584, 6 clinicians

Practice addresses (Care Compare)

21370 John Milless Dr
Suite 210
Rogers, MN 55374-4622
Phone (763) 428-2288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Arts, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Psychiatry, LLC CurrentSince May 1, 2017 Accepting new patients

Locations

303 Credit Union Dr
Ste 12B
Isanti, MN 55040
Phone (763) 428-2288

21370 John Milless Dr
Ste 210
Rogers, MN 55374
Phone (763) 428-2288

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1588700702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21370 JOHN MILLESS DR",
            "address_2": "SUITE #210",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553749449",
            "telephone_number": "763-428-2288",
            "fax_number": "763-428-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21370 JOHN MILLESS DR",
            "address_2": "SUITE #210",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553749449",
            "telephone_number": "763-428-2288",
            "fax_number": "763-428-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZINKEN",
        "first_name": "DEBRA",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "MA, RN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R101756-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "CHRISTIANSON",
            "middle_name": "C",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rogers, MN

Sources for this page

Verify at the official NPI Registry.