Individual provider Active NPI

Suzanne Gene Everson, RN, MSN, CNP

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1699794479
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R110048-8 Issued in MN
Practice address
1 Veterans Dr
Minneapolis, MN 55417-2309
Phone
(612) 725-2000
Fax
(612) 727-5973
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R110048-8 MN Primary

Addresses

Primary practice location

1 Veterans Dr
Minneapolis, MN 55417-2309

Mailing address

12378 Coffee TRL
Rosemount, MN 55068-3545
Phone (651) 423-6283

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
I20160302002864 MN Order and Referring Only - Nurse Practitioner 6103002001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R110048-8MNMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699794479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12378 COFFEE TRL",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550683545",
            "telephone_number": "651-423-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-725-2000",
            "fax_number": "612-727-5973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERSON",
        "first_name": "SUZANNE",
        "middle_name": "GENE",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R110048-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.