Active NPI
Rebecca Elisabeth Conner, NP
- Nurse Practitioner
- Saint Paul, MN
National Provider Identifier
1710096854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R100782-4
- Practice address
- 45 10TH St W
Saint Paul, MN 55102-1062 - Phone
- (651) 326-4012
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R100782-4 | MN | Primary |
Addresses
Primary practice location
45 10TH St W
Saint Paul, MN 55102-1062
Mailing address
9757 Washburn Ave N
Brooklyn Park, MN 55444-1017
Phone (763) 493-4056
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R100782-4 | MN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338422400000",
"number": "1710096854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9757 WASHBURN AVE N",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554441017",
"telephone_number": "763-493-4056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 10TH ST W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551021062",
"telephone_number": "651-326-4012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNER",
"first_name": "REBECCA",
"middle_name": "ELISABETH",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2012-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "R100782-4",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.