Individual provider Active NPI

Roberta Ann Seelen-Wolf, R.N.

  • Registered Nurse
  • Minneapolis, MN
National Provider Identifier
1952855918
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R099855-3 Issued in MN
Practice address
3100 W Lake St
210
Minneapolis, MN 55416-4527
Phone
(612) 925-6033
Fax
(612) 925-8496
NPI assigned
Aug 8, 2016
Last updated
Aug 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R099855-3 MN Primary

Addresses

Primary practice location

3100 W Lake St
210
Minneapolis, MN 55416-4527

Mailing address

3100 W Lake St
210
Minneapolis, MN 55416-4527
Phone (612) 925-6033

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

LicenseStateTypeSpecialty
R099855-3MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinic of Psychology Inc PastSince Jul 31, 2006 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1952855918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 W LAKE ST",
            "address_2": "210",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164527",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 W LAKE ST",
            "address_2": "210",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164527",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEELEN-WOLF",
        "first_name": "ROBERTA",
        "middle_name": "ANN",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R099855-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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.