KIMBERLY DE PAULO (NPI# 1417308701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417308701 |
| Entity Type | Individual |
| Full Name | KIMBERLY DE PAULO |
| Practice Address |
2200 Nw 26th St Owatonna MN 55060 |
| Mailing Address |
2200 Nw 26th St Owatonna MN 55060-5503 |
| Practice Telephone | 5074511120 |
| Mailing Telephone | 5074511120 |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2020-10-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 2445948 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363L00000X | Nurse Practitioner | 5070 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | R204304 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 1st St Sw, Rochester, MN 559050001 | 5072842511 |
| Street Address |
2200 NW 26TH ST |
| City | OWATONNA |
| State | MN |
| Zip Code | 55060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154324846 | Sara L. Packard | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2005-05-27 |
| 1275146680 | Jessica K Phelps | Nurse Practitioner | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2020-08-25 |
| 1588299804 | Cayla Kathleen Witte | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2020-03-06 |
| 1457909384 | Aicha Sylvie Katty | Nurse Practitioner | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-09-04 |
| 1366091266 | Melanie Kay Busch | Nurse Practitioner | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-09-04 |
| 1013576982 | Brady Michael Gross | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-06-13 |
| 1023573193 | Kayla Marie Cook | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-02-04 |
| 1467926618 | Megan Alm | Physician Assistant | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-01-21 |
| 1356814271 | Mallory Lynn Berry | Family Medicine | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2019-01-03 |
| 1801313796 | Melinda Louann Wiese | Nurse Practitioner | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2017-08-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669936480 | Lee Joseph Bakewell | Nurse Practitioner | 2200 Nw 26th St, Owatonna, Owatonna, MN 55060 | 2019-01-25 |
| 1275028227 | Karen Brennhofer | Audiologist | 2200 Nw 26th St Apt 309, Owatonna, MN 55060 | 2018-06-22 |
| 1801326418 | Katharyn Kristin Stricklin | Registered Nurse | 1961 Premier Drive, Suite 340 Mankato, Mankato, MN 55060 | 2017-06-15 |
| 1134666753 | Holly Christianson | Social Worker | 2575 Harvest Lane Nw, Owatonna, MN 55060 | 2017-01-20 |
| 1346613031 | Birchwood Cottages | Assisted Living Facility | 1905 Austin Road, Owatonna, MN 55060 | 2015-11-04 |
| 1881080067 | Cory Michael Kopas | Chiropractor | 130 26th Street Nw, Owatonna, MN 55060 | 2015-04-14 |
| 1528456613 | Quality Home Health Care Inc. | Home Health | 201 East Front Street, Owatonna, MN 55060 | 2014-12-26 |
| 1194017624 | Amy Louise Haycraft | Nurse Practitioner | South Central Human Relations Center, 610 Florence Ave, Owatonna, MN 55060 | 2011-05-02 |
| 1710123971 | Rahn Optometry Inc | Optometrist | 1130 W. Frontage Rd, Owatonna, MN 55060 | 2008-12-18 |
| 1063616993 | Michael John Dickman | Dentist | 1414 S Oak Ave Suite Five, Owatonna, MN 55060 | 2007-06-13 |
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| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194017624 | Amy Louise Haycraft | Nurse Practitioner | South Central Human Relations Center, 610 Florence Ave, Owatonna, MN 55060 | 2011-05-02 |
| 1275146680 | Jessica K Phelps | Nurse Practitioner | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2020-08-25 |
| 1801313796 | Melinda Louann Wiese | Nurse Practitioner | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2017-08-23 |
| 1639404098 | Jessica J Johnson | Nurse Practitioner | 2200 Nw 26th St, Owatonna, MN 55060-5503 | 2009-10-02 |
| 1942261151 | Joan M Queen | Nurse Practitioner | 134 Southview St, Owatonna, MN 55060-3241 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841803970 | Kelsey Olson | Nurse Practitioner | 2450 Riverside Ave Fl 9, Minneapolis, MN 55454-1450 | 2020-08-28 |
| 1043821622 | Byron Howard Herdman | Nurse Practitioner | 20671 State Highway 29, Henning, MN 56551-9521 | 2020-08-16 |
| 1568071058 | Miranda Bea Irene Charley | Nurse Practitioner | 510 Water St E, Cannon Falls, MN 55009-1643 | 2020-07-30 |
| 1861001059 | Angelsisters Home Healthcare Servies LLC | Nurse Practitioner | 10001 Butternut Cir N, Brooklyn Park, MN 55443-1864 | 2020-07-24 |
| 1720606544 | Kendra Marie Robida | Nurse Practitioner | 7245 Guider Dr Apt 317, Woodbury, MN 55125-5358 | 2020-07-08 |
| 1568089340 | Emily Abernethy | Nurse Practitioner | 1001 E Superior St Ste 401, Duluth, MN 55802-2229 | 2020-06-29 |
| 1487276556 | Kerriann Godwin | Nurse Practitioner | 842 102nd Ln Ne, Blaine, MN 55434-2642 | 2020-05-12 |
| 1699397851 | School of Health LLC | Nurse Practitioner | 30165 Terryll St, Lindstrom, MN 55045-9310 | 2020-05-11 |
| 1255953626 | Carla Renea Boudoir | Nurse Practitioner | 18342 Kerrville Trl, Lakeville, MN 55044-7310 | 2020-05-08 |
| 1639799745 | Elizabeth Carole Moe | Nurse Practitioner | 2151 Troop Dr, Sartell, MN 56377-4563 | 2020-04-17 |
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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.