CVS Caremark Minuteclinic

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2014010271 Issued in MN

Legal business name

CVS CAREMARK MINUTECLINIC

Practice address

15051 Galaxie Ave
Apple Valley, MN 55124-6987

Phone

(952) 432-3535

NPI assigned

Sep 21, 2014

Organization subpart

No

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

Authorized official

Name

Holly Dumaine-Picard

Title

Credentialing Coordinator

Phone

(401) 770-9323

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1411257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411257600000",
    "number": "1861894941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3345 HARRIET AVE # 4",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083729",
            "telephone_number": "612-702-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15051 GALAXIE AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246987",
            "telephone_number": "952-432-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS CAREMARK MINUTECLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-21",
        "last_updated": "2014-09-21",
        "status": "A",
        "authorized_official_last_name": "DUMAINE-PICARD",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "401-770-9323"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "2014010271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2014; 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.