Active NPI
Delebah Lawoh Reed-Yaidoo
- Psychiatric/Mental Health Nurse Practitioner
- Plymouth, MN
National Provider Identifier
1932891504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 10279
- Practice address
- 11505 36TH Ave N
Plymouth, MN 55441-2304 - Phone
- (877) 803-1520
- NPI assigned
- May 23, 2023
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 10279 | MN | Primary |
Addresses
Primary practice location
11505 36TH Ave N
Plymouth, MN 55441-2304
Mailing address
6430 Marshall Ave NE
Otsego, MN 55301-4656
Phone (763) 300-9391
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10279 | MN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1932891504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6430 MARSHALL AVE NE",
"city": "OTSEGO",
"state": "MN",
"postal_code": "553014656",
"telephone_number": "763-300-9391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11505 36TH AVE N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554412304",
"telephone_number": "877-803-1520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REED-YAIDOO",
"first_name": "DELEBAH",
"middle_name": "LAWOH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-23",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MN",
"license": "10279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.