Individual provider Active NPI

Kaitlyn Grausam, DNP, APRN, CNP

  • Gerontology Nurse Practitioner
  • Richfield, MN
National Provider Identifier
1730892944
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
9570 Issued in MN
Practice address
7333 Blaisdell Ave
Richfield, MN 55423-3115
Phone
(612) 240-1917
NPI assigned
Jan 3, 2023
Last updated
Dec 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9570 MN
Adult Health Nurse Practitioner 363LA2200X 9570 MN
Gerontology Nurse Practitioner 363LG0600X 9570 MN Primary
Primary Care Nurse Practitioner 363LP2300X 9570 MN

Addresses

Primary practice location

7333 Blaisdell Ave
Richfield, MN 55423-3115

Mailing address

7333 Blaisdell Ave
Richfield, MN 55423-3115
Phone (612) 240-1917

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
I20241203003907 MN Practitioner - Nurse Practitioner 7618349309

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

270 Main St N
Suite 300
Stillwater, MN 55082-6788

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9570MNMDSpeech-Language Pathologist

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1730892944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7333 BLAISDELL AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554233115",
            "telephone_number": "612-240-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7333 BLAISDELL AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554233115",
            "telephone_number": "612-240-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAUSAM",
        "first_name": "KAITLYN",
        "credential": "DNP, APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "9570",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "9570",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "9570",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "9570",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

Verify at the official NPI Registry.