Callen B Kibagendi, NURSE PRACTITIONER

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

8229 Issued in MN

Practice address

100 Washington Ave S
Minneapolis, MN 55401-2110

Phone

(000) 000-0000

NPI assigned

Sep 24, 2021

Last updated

Sep 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1669143129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9382",
            "city": "NORTH SAINT PAUL",
            "state": "MN",
            "postal_code": "551090382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WASHINGTON AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012110",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIBAGENDI",
        "first_name": "CALLEN",
        "middle_name": "B",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-24",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "8229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie Lee Khong, PHARMD
• Shun Yi Khor, DDS
• Ameer Ali Khowaja, M.D.
• Aima Khurram, MD
• Arazu Kian, DNP, WHNP-BC
• Tania Maria Kibble, MD
• Kenneth M Kiberenge, MD
• Roy Kagumba Kiberenge, M.D.
• Tasha Kiberenge, PA
• George Mulinde Kibuuka

• Primary Care Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Primary Care Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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.