Individual provider Active NPI

Alana Rae Lewellyn, DNP, CNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1639977705
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
12885 Issued in MN
Practice address
1200 Kenwood Ave
Duluth, MN 55811-4199
Phone
(800) 447-5444
NPI assigned
Mar 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 2464216 MN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12885 MN Primary

Addresses

Primary practice location

1200 Kenwood Ave
Duluth, MN 55811-4199

Mailing address

1200 Kenwood Ave
Duluth, MN 55811-4199

Other practice location 1

101 Dehler Dr
Sartell, MN 56377-4407
Phone (320) 253-3512

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
I20250626002213 MN Practitioner - Nurse Practitioner 5496267148 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2464216MNMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Family Support Services Inc. CurrentSince Jul 7, 2025 Accepting new patients
Nystrom & Associates, LTD CurrentSince Jul 7, 2025 Accepting new patients

Locations

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

101 Dehler Dr
Sartell, MN 56377
Phone (320) 253-3512

Organizations & group practices 2

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": "1741132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1639977705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 KENWOOD AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 KENWOOD AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114199",
            "telephone_number": "800-447-5444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dehler Dr",
            "address_purpose": "LOCATION",
            "city": "Sartell",
            "state": "MN",
            "postal_code": "563774407",
            "country_code": "US",
            "telephone_number": "320-253-3512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWELLYN",
        "first_name": "ALANA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "DNP, CNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MN",
            "license": "2464216",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "12885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.