MRS. MANDY RAE BLUME (NPI# 1134378433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134378433 |
| Entity Type | Individual |
| Full Name | MRS. MANDY RAE BLUME |
| Other Name | MISS MANDY RAE BUTTERFIELD |
| Credential | MS RN CGNP |
| Practice Address |
4810 197th St E Faribault MN 55021-8078 |
| Practice Telephone | 5073332748 |
| Mailing Telephone | 5073332748 |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2010-12-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
R156724-1 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4810 197TH ST E |
| City | FARIBAULT |
| State | MN |
| Zip Code | 55021-8078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872831 | Kent William Lundstrom | Pharmacist | 612 4th Street Nw, Faribault, MN 55021 | 2020-08-19 |
| 1053957357 | M&t Sisters of Serendipity Pllc | Counselor | 212a Centralave, Faribault, MN 55021 | 2019-11-21 |
| 1639720485 | Reliable Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 200 8th Avenue Nw, Faribault, MN 55021 | 2019-09-24 |
| 1235663428 | Tanya Borchert | Social Worker | 100 State Avenue, Faribault, MN 55021 | 2017-04-14 |
| 1235589854 | Bashir Omar I | Interpreter | 2426 Park Ave # 309, Faribault, MN 55021 | 2016-06-14 |
| 1790150381 | Rainbow United Care Transportation LLC | Non-emergency Medical Transport (VAN) | 1738 Patrick Bay, Faribault, MN 55021 | 2015-12-08 |
| 1740625938 | Steven James Klapmeier | Family Medicine | 1101 Linden Lane, Mcfffrb Health Service, Faribault, MN 55021 | 2013-05-02 |
| 1528306040 | Discovery Public School of Faribault | Local Education Agency (LEA) | 126 8th St. Nw, Faribault, MN 55021 | 2013-01-17 |
| 1164790374 | Emmanuel Douah | Pharmacist | 612 4th Avenue Nw, Faribault, MN 55021 | 2011-12-02 |
| 1770873937 | Faribault Senior Living LLC | Assisted Living Facility | 843 Faribault Road, Faribault, MN 55021 | 2011-04-08 |
| Find all providers in zip 55021 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578597407 | Peggy Vee Dunton | Nurse Practitioner | 924 1st St Ne, Faribault, MN 55021-5441 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619587193 | Sadiya Abdirahman Esse | Nurse Practitioner | 1690 Silver Lake Rd Nw, New Brighton, MN 55112-1788 | 2020-08-09 |
| 1881226512 | Abby Marie Zenner | Nurse Practitioner | 1771 Countryside Dr, Shakopee, MN 55379-4451 | 2020-02-11 |
| 1174019038 | Adedayo Temitope Dosumu | Nurse Practitioner | 816 50th Ave Nw, Rochester, MN 55901-6554 | 2018-07-03 |
| 1407223159 | Carla Sue Christenson | Nurse Practitioner | 3400 W. 66th St, Edina, MN 55435 | 2015-08-28 |
| 1538573449 | Rebecca Anne Lenz | Nurse Practitioner | 1172 Randolph Ave Apt 8, Saint Paul, MN 55105-2987 | 2014-06-18 |
| 1083027536 | Mueni C Mualuko | Nurse Practitioner | 2220 Riverside Ave # Ms 26602g, Geriatrics Department Ms 26602g/ 2220 Riverside Ave, Minneapolis, MN 55454-1321 | 2014-06-03 |
| 1659623999 | Joy Laansma | Nurse Practitioner | 3366 Oakdale Avenue North, Suite 551, Robbinsdale, MN 55422-2948 | 2012-10-10 |
| 1720337694 | Zhonghua Xie | Nurse Practitioner | 1202 5th Grant Blvd W, Wabasha, MN 55981-1115 | 2012-09-06 |
| 1487937892 | Jonathan Deforest Olson | Nurse Practitioner | 30 W 22nd St, #204, Minneapolis, MN 55404-2428 | 2011-09-21 |
| 1548577224 | Lorene Ann Gray | Nurse Practitioner | 6465 W Shadow Lake Dr, Lino Lakes, MN 55014-1982 | 2010-09-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.