Katie Michelle Annen, N.P.
Individual provider Active NPI Family Nurse Practitioner · Buffalo, MN
NPI 1720330632 · NPPES record last updated Oct 3, 2012
Key facts
- NPI
- 1720330632
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R1703966 (MN)
- Practice address
- 303 Catlin St
Buffalo, MN 55313-1947 - Phone
- (612) 669-0365
- NPI assigned
- Oct 3, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2025 through Jul 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1703966 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Past | Accepting new patients | |
| Five Elements Spa LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R1703966 | MN | Yes |
Addresses
Primary practice location
303 Catlin St
Buffalo, MN 55313-1947
Mailing address
303 Catlin St
Buffalo, MN 55313-1947
Phone (612) 669-0365
Other providers in Buffalo, MN
- Kayla Het Nguyen Anderson
- Kylie Miranda Anderson
- Nolan Paul Anderson
- Rebecca Susan Anderson
- Taylor Lee Andrews
- Arcs Institute LLC
- Crystal Aurich
- Carol Jean Averbeck
- Awaken Life Recovery, LLC
- Kelli Bader
All providers in Buffalo, MN · Family Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.