Individual provider Active NPI

Shari Bernice Duwenhoegger

  • Licensed Practical Nurse
  • Maple Grove, MN
National Provider Identifier
1780143453
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
L59057-8 Issued in MN
Practice address
9037 Garland LN N
Maple Grove, MN 55311-1285
Phone
(612) 481-5629
NPI assigned
Mar 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L59057-8 MN Primary

Addresses

Primary practice location

9037 Garland LN N
Maple Grove, MN 55311-1285

Mailing address

9037 Garland LN N
Maple Grove, MN 55311-1285
Phone (612) 481-5629

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L59057-8MNMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1780143453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9037 GARLAND LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553111285",
            "telephone_number": "612-481-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9037 GARLAND LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553111285",
            "telephone_number": "612-481-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUWENHOEGGER",
        "first_name": "SHARI",
        "middle_name": "BERNICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "L59057-8",
            "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 Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.