Active NPI
Julie Jacobs, RN
- Registered Nurse
- Stillwater, MN
National Provider Identifier
1700402484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 129243-5
- Practice address
- 7400 Manning Ave N
Stillwater, MN 55082-8419 - Phone
- (651) 283-5116
- NPI assigned
- Jun 18, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 129243-5 | MN | Primary |
Addresses
Primary practice location
7400 Manning Ave N
Stillwater, MN 55082-8419
Mailing address
7400 Manning Ave N
Stillwater, MN 55082-8419
Phone (651) 283-5116
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 129243-5 | Other | MN | MINNESOTA BOARD OF NURSING |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | kingdompathways@mdofficemail.com | Direct |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 129243-5 | MN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592438400000",
"number": "1700402484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7400 MANNING AVE N",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550828419",
"telephone_number": "651-283-5116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 MANNING AVE N",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550828419",
"telephone_number": "651-283-5116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "JULIE",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-18",
"last_updated": "2020-06-18",
"certification_date": "2020-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "129243-5",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MINNESOTA BOARD OF NURSING",
"identifier": "129243-5",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "kingdompathways@mdofficemail.com",
"affiliation": "N",
"endpointDescription": "Secure Email Inbox",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "PHI",
"address_1": "1034 Aurora Ave",
"city": "Saint Paul",
"state": "MN",
"country_code": "US",
"postal_code": "551044713",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Stillwater, MN
- Infinite Health Collaborative, PA
- Integrated Energetic Alignment LLC
- Integrated Health & Rehabilitation Center(Ihrc), PLLC
- Integrative Psychological Services, P.a.
- Integrity Dental Care, P.a.
- Annie M Jacobsen, M.D.
- Kevin Joseph Jacques
- Samantha Barke Jamison, MSN, CNP, AGPCNP-BC
- Elibelle R Jardio, BSN
- Cortney Lynn Jarvey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.