Individual provider Active NPI

Rita Andik Anang

  • Psychiatric/Mental Health Nurse Practitioner
  • Otsego, MN
National Provider Identifier
1679404024
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
14252 Issued in MN
Practice address
12103 78TH St NE
Otsego, MN 55330-4823
Phone
(612) 607-9421
NPI assigned
May 26, 2026
Last updated
May 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 14252 MN Primary

Addresses

Primary practice location

12103 78TH St NE
Otsego, MN 55330-4823

Mailing address

12103 78TH St NE
Otsego, MN 55330-4823
Phone (612) 607-9421

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

State licenses

LicenseStateTypeSpecialty
14252MNMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1779753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1679404024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12103 78TH ST NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553304823",
            "telephone_number": "612-607-9421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12103 78TH ST NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553304823",
            "telephone_number": "612-607-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANANG",
        "first_name": "RITA",
        "middle_name": "ANDIK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-26",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "14252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Otsego, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.