Organization Active NPI

Karen N. Tudahl, Pmhnp-BC, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Minot, ND
National Provider Identifier
1841960416
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
KAREN N. TUDAHL, PMHNP-BC, PLLC
Practice address
24 Main St N Ste E
Minot, ND 58703-3104
Phone
(701) 394-5026
Fax
(701) 516-8026
NPI assigned
Sep 15, 2021
Last updated
Oct 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Authorized official

Name
Karen Nichole Tudahl, PMHNPNPI 1659707610
Title
Owner/Provider
Phone
(701) 394-5026

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

24 Main St N Ste E
Minot, ND 58703-3104

Mailing address

24 Main St N Ste E
Minot, ND 58703-3104
Phone (701) 394-5026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220112001519 ND Part B Supplier - Clinic/Group Practice 2163814633 Receives reassigned benefits from 1 practitioner
Practice locations: Minot, ND

National Provider Directory

National Provider Directory

Locations

24 Main St N
Ste E
Minot, ND 58703
Phone (701) 394-5026

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633478400000",
    "number": "1841960416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MAIN ST N STE E",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587033104",
            "telephone_number": "701-394-5026",
            "fax_number": "701-419-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MAIN ST N STE E",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587033104",
            "telephone_number": "701-394-5026",
            "fax_number": "701-516-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN N. TUDAHL, PMHNP-BC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A",
        "authorized_official_last_name": "TUDAHL",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "701-394-5026",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.