Active NPI
Jan Elaine Youngblood, APRN, FNP-C
- Family Nurse Practitioner
- Champlin, MN
National Provider Identifier
1720042625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- CNP2892
- Practice address
- 11990 Business Park Blvd N
Champlin, MN 55316-2005 - Phone
- (402) 598-2365
- NPI assigned
- Apr 17, 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | CNP2892 | MN | Primary |
Addresses
Primary practice location
11990 Business Park Blvd N
Champlin, MN 55316-2005
Mailing address
3808 Drew Ave S
Minneapolis, MN 55410-1046
Phone (402) 598-2365
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP2892 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alegent Health Quick Care LLC | Past | Accepting new patients | |
| Alegent Creighton Clinic | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba CHI Health Quick Care LLC
- Family Medicine Physician
- Council Bluffs, IA
- NPI 1083139224
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459900800000",
"number": "1720042625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3808 DREW AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554101046",
"telephone_number": "402-598-2365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11990 BUSINESS PARK BLVD N",
"city": "CHAMPLIN",
"state": "MN",
"postal_code": "553162005",
"telephone_number": "402-598-2365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGBLOOD",
"first_name": "JAN",
"middle_name": "ELAINE",
"name_prefix": "Mrs.",
"credential": "APRN, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-17",
"last_updated": "2016-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "CNP2892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champlin, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.