Active NPI
Rolla Crandall, TM
- Lay Midwife
- Brooklyn Park, MN
National Provider Identifier
1801029491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lay Midwife
- Practice address
- 7033 Idaho Ave N
Brooklyn Park, MN 55428-1781 - Phone
- (612) 735-0396
- NPI assigned
- Aug 28, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Lay Midwife | 175M00000X | Primary |
Addresses
Primary practice location
7033 Idaho Ave N
Brooklyn Park, MN 55428-1781
Mailing address
7033 Idaho Ave N
Brooklyn Park, MN 55428-1781
Phone (612) 735-0396
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251417600000",
"number": "1801029491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7033 IDAHO AVE N",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554281781",
"telephone_number": "612-735-0396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7033 IDAHO AVE N",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554281781",
"telephone_number": "612-735-0396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANDALL",
"first_name": "ROLLA",
"credential": "TM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-28",
"last_updated": "2009-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "175M00000X",
"taxonomy_group": "",
"desc": "Midwife, Lay",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.