Nicole Anderson, APRN, CNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Stillwater, MN
NPI 1902489339 · NPPES record last updated May 3, 2021
Key facts
- NPI
- 1902489339
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 8178 (MN)
- Practice address
- 1715 Tower Dr W Ste 100
Stillwater, MN 55082-7609 - Phone
- (651) 390-5001
- NPI assigned
- May 3, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Certified Clinical Nurse Specialist (CNS)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Nystrom and Associates LTD
Nystrom and Associates Counseling Wi SC
Practice addresses (Care Compare)
1715 Tower Dr W
Suite 100
Stillwater, MN 55082-7609
Phone (651) 390-5001
201 Main St
Suite 500
La Crosse, WI 54601-0716
Phone (608) 668-4005
Hospital & facility affiliations
- M Health Fairview University of MN Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.07 of 100
- Quality
- 47.76
- Promoting interoperability
- 95
- Improvement activities
- 40
- Cost
- 91.34
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210607001014 | MN | Practitioner - Certified Clinical Nurse Specialist (CNS) | 1456751866 | Reassigns benefits to 1 organization |
| I20210805001893 | WI | Practitioner - Certified Clinical Nurse Specialist (CNS) | 1456751866 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8178 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nystrom & Associates Counseling Wi., S.C. | Current |
Accepting new patients | |
| Nystrom & Associates Counseling Wi., S.C. | Current |
Accepting new patients | |
| Nystrom & Associates, LTD | Current |
Accepting new patients |
Locations
1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704
1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718
1715 Tower Dr W
Ste 100
Stillwater, MN 55082
Phone (651) 275-4180
3703 Oakwood Hills Pkwy
Ste 100
Eau Claire, WI 54701
Phone (534) 444-4562
2501 Hanley Rd
Ste 201
Hudson, WI 54016
Phone (534) 544-5247
201 Main St
Ste 500
La Crosse, WI 54601
Phone (608) 668-4005
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 8178 | MN | Yes |
Addresses
Primary practice location
1715 Tower Dr W Ste 100
Stillwater, MN 55082-7609
Mailing address
1210 Oakey CT
Osceola, WI 54020-4359
Phone (651) 206-2163
Other providers in Stillwater, MN
- Cassie Anderson
- Elizabeth R Anderson
- Kyle Robert Anderson
- Leigha Anderson
- Lindsey Marie Kolnik Anderson
- Thomas S Anderson
- Caitlin Rae Anear
- Jane Louise Anglin
- Shatarah Marie Angline
- Sierra Anuforo
All providers in Stillwater, MN · Psychiatric/Mental Health Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.