Individual provider Active NPI

Elizabeth Kathryn Herrity, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1679923072
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
CNP 4582 Issued in MN
Practice address
701 Park Ave
Minneapolis, MN 55415
Phone
(612) 873-3000
Fax
(612) 904-4567
NPI assigned
Jun 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X CNP 4582 MN Primary

Addresses

Primary practice location

701 Park Ave
Minneapolis, MN 55415

Mailing address

701 Park Ave
Minneapolis, MN 55415-1623
Phone (602) 300-3409

Other practice location 1

2520 W Medicine Lake Dr
Plymouth, MN 55441-4148
Phone (602) 300-3409

Other practice location 2

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 273-3000

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)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4582MNMDMental Health Counselor
CNP 4582MNMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1679923072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "602-300-3409",
            "fax_number": "612-904-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55415",
            "telephone_number": "612-873-3000",
            "fax_number": "612-904-4567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2520 W Medicine Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554414148",
            "country_code": "US",
            "telephone_number": "602-300-3409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Harvard St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550363",
            "country_code": "US",
            "telephone_number": "612-273-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRITY",
        "first_name": "ELIZABETH",
        "middle_name": "KATHRYN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MN",
            "license": "CNP 4582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.