Active NPI
Paulette Sirucek, RN, LPN
- Registered Nurse
- Motley, MN
National Provider Identifier
1861228199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 2509877
- Practice address
- 10640 92ND Ave SW
Motley, MN 56466-2545 - Phone
- (218) 640-6200
- NPI assigned
- Sep 12, 2024
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2509877 | MN | Primary |
Addresses
Primary practice location
10640 92ND Ave SW
Motley, MN 56466-2545
Mailing address
722 NW 7TH St
Brainerd, MN 56401-2912
Phone (218) 855-1115
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2509877 | MN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743552000000",
"number": "1861228199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "722 NW 7TH ST",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564012912",
"telephone_number": "218-855-1115",
"fax_number": "218-855-1183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10640 92ND AVE SW",
"city": "MOTLEY",
"state": "MN",
"postal_code": "564662545",
"telephone_number": "218-640-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIRUCEK",
"first_name": "PAULETTE",
"credential": "RN, LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-12",
"last_updated": "2025-04-02",
"certification_date": "2025-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "2509877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Motley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.