Millicent Boa-Amponsem, DNP, PMHNP-BC, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

8696 Issued in MN

Practice address

14800 Galaxie Ave Ste 305
Apple Valley, MN 55124-4530

Phone

(952) 432-1484

Fax

(952) 432-2328

NPI assigned

Jul 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Associated Clinic of Psychology IncGroup PAC ID 0749171320, 136 clinicians

Cornerstone Montgomery IncGroup PAC ID 3971591751, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Associated Clinic of Psychology Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Louis Park, MN
  • NPI 1588741292
  Medicare reassignment Care Compare group NPD
• Cornerstone Montgomery, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bethesda, MD
  • NPI 1194725739

  DC

  Medicare reassignment Care Compare group NPD
• Fairview Express Care

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

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment NPD
• Healtheast Medical Research Institute

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment NPD
• Hennepin County

  • Psychiatry Physician
  • Minneapolis, MN
  • NPI 1780790345

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Blaine, MN
  • NPI 1417277294
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Healtheast Medical Research Institute

  • Internal Medicine Physician
  • Saint Paul, MN
  • NPI 1508191552
  NPD
• Cornerstone Montgomery, Inc.

  • Adult Mental Health Clinic/Center
  • Silver Spring, MD
  • NPI 1174995781
  NPD

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1659858769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 PARK GLEN RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165427",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 GALAXIE AVE STE 305",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551244530",
            "telephone_number": "952-432-1484",
            "fax_number": "952-432-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOA-AMPONSEM",
        "first_name": "MILLICENT",
        "credential": "DNP, PMHNP-BC, CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "1971170",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R213614",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R213614",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley R Biagi
• Colin Benjamin Harmon Bigalke
• Tristyn Bigaouette
• Kristin Blegen
• Blue Care Transportation LLC
• John Boettger
• Zachary Bolin, P.A.
• Christine Marie Bomsta, CMT
• Elizabeth Bonifacic, LADC
• Carol Lynn Borden, PH.D., LPCC

• Psychiatric/Mental Health Nurse Practitioner in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.