Individual provider Active NPI

Patricia Lynn Earley

  • Family Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1942230263
Registry record updated Apr 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R1369122 Issued in MN
Practice address
4621 E Superior St
Duluth, MN 55804-2338
Phone
(218) 876-3550
Fax
(218) 525-7487
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R1369122 MN Primary

Addresses

Primary practice location

4621 E Superior St
Duluth, MN 55804-2338

Mailing address

4621 E Superior St
Duluth, MN 55804-2338
Phone (218) 876-3550

Other identifiers 1

IdentifierTypeStateIssuer
43947800MedicaidMN

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
8311WIMDCounselor
R1369122MNMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304035200000",
    "number": "1942230263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4621 E SUPERIOR ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558042338",
            "telephone_number": "218-876-3550",
            "fax_number": "218-525-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 E SUPERIOR ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558042338",
            "telephone_number": "218-876-3550",
            "fax_number": "218-525-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLEY",
        "first_name": "PATRICIA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R1369122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43947800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; 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.