Individual provider Active NPI

Jenna Miller, CNP

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1770391476
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
12395 Issued in MN
Practice address
500 Harvard St SE
Minneapolis, MN 55455-0363
Phone
(612) 273-8383
NPI assigned
Dec 26, 2024
Last updated
Dec 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 12395 MN Primary

Addresses

Primary practice location

500 Harvard St SE
Minneapolis, MN 55455-0363

Mailing address

21018 Bittersweet Dr
Lenexa, KS 66220-3256

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
I20250116001297 MN Practitioner - Nurse Practitioner 4880122993 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12395MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Mar 10, 2025 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Mar 10, 2025 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Physicians CurrentSince Mar 10, 2025 Accepting new patients
Fairview Express Care CurrentSince Mar 10, 2025 Accepting new patients
University of Minnesota Physicians CurrentSince Mar 10, 2025 Accepting new patients
Fairview Express Care CurrentSince Mar 10, 2025 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

6525 France Ave S
Ste 200
Minneapolis, MN 55435
Phone (952) 848-8890

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0331

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

Interoperability endpoints

  • Direct secure messaging: jmiller2637828@fairview.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1735171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1770391476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21018 BITTERSWEET DR",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662203256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HARVARD ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550363",
            "telephone_number": "612-273-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-26",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "12395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.