Individual provider Active NPI

Cortney Michelle Olejniczak, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Eden Prairie, MN
National Provider Identifier
1801311303
Registry record updated Aug 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5341 Issued in MN
Practice address
6442 City West Pkwy # 200
Eden Prairie, MN 55344-3245
Phone
(763) 318-2800
NPI assigned
Aug 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5341 MN Primary

Addresses

Primary practice location

6442 City West Pkwy # 200
Eden Prairie, MN 55344-3245

Mailing address

58 Woodberry Dr
Delafield, WI 53018-1816
Phone (715) 579-8048

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
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5341MNMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502064000000",
    "number": "1801311303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 WOODBERRY DR",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530181816",
            "telephone_number": "715-579-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6442 CITY WEST PKWY # 200",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443245",
            "telephone_number": "763-318-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLEJNICZAK",
        "first_name": "CORTNEY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2017-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "5341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; 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.