Active NPI
Carmen Stansberry, C.N.P.
- Women's Health Nurse Practitioner
- Maple Grove, MN
National Provider Identifier
1770879538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- R203344-4
- Practice address
- 9825 Hospital Dr #205
Maple Grove, MN 55369 - Phone
- (763) 587-7000
- Fax
- (763) 587-7015
- NPI assigned
- Jun 21, 2011
- 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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | R203344-4 | MN | Primary |
Addresses
Primary practice location
9825 Hospital Dr #205
Maple Grove, MN 55369
Mailing address
5700 Bottineau Blvd #210
Crystal, MN 55429
Phone (763) 587-7000
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
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R203344-4 | MN | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424822400000",
"number": "1770879538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5700 BOTTINEAU BLVD #210",
"city": "CRYSTAL",
"state": "MN",
"postal_code": "55429",
"telephone_number": "763-587-7000",
"fax_number": "763-587-7015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9825 HOSPITAL DR #205",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "55369",
"telephone_number": "763-587-7000",
"fax_number": "763-587-7015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANSBERRY",
"first_name": "CARMEN",
"name_prefix": "Mrs.",
"credential": "C.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-21",
"last_updated": "2015-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "MN",
"license": "R203344-4",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.