Individual provider Active NPI

Jennifer Joy Berreau

  • Ambulatory Care Registered Nurse
  • Cottage Grove, MN
National Provider Identifier
1619883907
Registry record updated Aug 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
1368835 Issued in MN
Practice address
9156 Indian Blvd S
Cottage Grove, MN 55016-5218
Phone
(612) 816-1737
NPI assigned
Aug 19, 2026
Last updated
Aug 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 1368835 MN Primary

Addresses

Primary practice location

9156 Indian Blvd S
Cottage Grove, MN 55016-5218

Mailing address

9156 Indian Blvd S
Cottage Grove, MN 55016-5218
Phone (651) 458-0458

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1787097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787961600000",
    "number": "1619883907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9156 INDIAN BLVD S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550165218",
            "telephone_number": "651-458-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9156 INDIAN BLVD S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550165218",
            "telephone_number": "612-816-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERREAU",
        "first_name": "JENNIFER",
        "middle_name": "JOY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-19",
        "last_updated": "2026-08-29",
        "certification_date": "2026-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MN",
            "license": "1368835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.