Jenna Rae Eisold, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

7231 Issued in MN

Practice address

65 W Wood Ridge Dr
River Falls, WI 54022-8291

Phone

(763) 229-3744

NPI assigned

Feb 11, 2020

Last updated

Feb 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jenna Rae Earley Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Childrens Health Care

  • Pediatrics Physician
  • Minneapolis, MN
  • NPI 1932208808
  Medicare reassignment NPD
• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Childrens Health Care

  • Hearing Aid Equipment
  • Minneapolis, MN
  • NPI 1790827905
  NPD
• Childrens Health Care

  • Children's Hospital
  • Minneapolis, MN
  • NPI 1881793750
  NPD
• Fairview Express Care

  dba Fairview Clinics Specialty

  • Specialist
  • Saint Paul, MN
  • NPI 1679048763
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1609408210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 W WOOD RIDGE DR",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540228291",
            "telephone_number": "763-229-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 W WOOD RIDGE DR",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540228291",
            "telephone_number": "763-229-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISOLD",
        "first_name": "JENNA",
        "middle_name": "RAE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "7231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "EARLEY",
            "middle_name": "RAE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paris Delisle
• Katherine J Delong-Hecker, M.D.
• Daniel Dibenedetto
• Kate Dulaney, MSC CCC SLP
• Shari Durch, ATC, RCEP
• Terry Lynn Ekstrom
• Ericksons Diversified LLC (Family Fresh Market Pharmacy)
• Stella Oyimma Essien, CNP
• Fairview Clinics (M Health Fairview Clinic River Falls)
• Fairview Pharmacy Service LLC (Fairview River Falls Clinic MTM)

• Pediatric Nurse Practitioner in River Falls, WI
• Providers in River Falls, WI by specialty
• Pediatric Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.