KATHLEEN ELIZABETH PENGELLY (NPI# 1760956668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760956668 |
Entity Type | Individual |
Full Name | KATHLEEN ELIZABETH PENGELLY |
Credential | CNP |
Practice Address |
762 Transfer Rd Ste 21 Saint Paul MN 55114-1489 |
Practice Telephone | 6516592900 |
Practice Fax Number | 6516457307 |
Mailing Telephone | 6519553397 |
Mailing Fax Number | 6516457307 |
Enumeration Date | 2019-01-15 |
Last Update Date | 2019-08-15 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
138239-0 | MN | Nursing Service Providers |
N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
6667 | MN | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
15420 Founders Ln, Apple Valley, MN 551246076 | 6516592900 | 9524315842 |
501 Highway 13 E Ste 116, Burnsville, MN 553372877 | 6516819366 | 6516819317 |
Street Address |
762 TRANSFER RD STE 21 |
City | SAINT PAUL |
State | MN |
Zip Code | 55114-1489 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437337656 | Mental Health Resources | Community/Behavioral Health | 762 Transfer Rd Ste 21, Saint Paul, MN 55114 | 2008-02-11 |
1720622996 | Jane Ann Welter-nolan | Psychologist | 762 Transfer Rd Ste 21, Saint Paul, MN 55114-1489 | 2019-10-31 |
1285277053 | Brenda Cecilia Guzman Galicia | Counselor | 762 Transfer Rd Ste 21, Saint Paul, MN 55114-1489 | 2019-10-23 |
1043852874 | Megan Jacobs | Social Worker | 762 Transfer Rd Ste 21, Saint Paul, MN 55114-1489 | 2019-10-14 |
1457905481 | Alyson Calo | Social Worker | 762 Transfer Rd Ste 21, Saint Paul, MN 55114-1489 | 2019-07-29 |
1962054205 | Lisa Rauschendorfer | Social Worker | 762 Transfer Rd Ste 21, Saint Paul, MN 55114-1489 | 2019-07-16 |
1538711502 | Anna Schuette Raudenbush | Social Worker | 762 Transfer Rd Ste 21, Saint Paul, MN 55114-1489 | 2019-07-10 |
1356903447 | Stephanie Kitzhaber | Social Worker | 762 Transfer Rd Ste 21, Saint Paul, MN 55114-1489 | 2019-06-28 |
1326608639 | Cassandra L Kirby | Counselor | 762 Transfer Rd Ste 21, Saint Paul, MN 55114 | 2019-06-18 |
1154883007 | Eileen G Anderson LLC | Community/Behavioral Health | 762 Transfer Rd Ste 21, Saint Paul, MN 55114-1489 | 2019-04-01 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790205698 | Der Yang | Registered Nurse | 2356 University Ave W #220, Saint Paul, MN 55114 | 2017-06-21 |
1679949358 | Mallory Haglund | Counselor | 284 West Rocky Lane, Boulder, NV 55114 | 2015-08-17 |
1083090880 | Kayla Estenson | Marriage & Family Therapist | 2324 University Ave West, 120, St. Paul, MN 55114 | 2015-08-04 |
1184023772 | Preetanjali Thakur | Dentist | 2550 University Avenue West Suite 189s, St Paul, MN 55114 | 2014-08-19 |
1023426210 | Melanie Bayer Witthoft | Social Worker | 762 Transfer Road, 21, St. Paul, MN 55114 | 2014-07-31 |
1184046518 | Britni Kelley | Marriage & Family Therapist | 821 Raymond Ave Ste 325, Saint Paul, MN 55114 | 2014-01-21 |
1205257581 | Arti Kaul | Dentist | 808 Berry St, Apy 126, St Paul, MN 55114 | 2014-01-03 |
1588907109 | Jesus M Calvillo | Counselor | 821 Raymond Ave Ste 230, Saint Paul, MN 55114 | 2013-04-02 |
1154669414 | Caringhands Home Health Care Inc. | Home Health | 2233 University Ave West, Suite 330, St Paul, MN 55114 | 2013-01-22 |
1396021424 | The Avalon Charter School | Local Education Agency (LEA) | 700 Glendale Street, Saint Paul, MN 55114 | 2011-11-03 |
Find all providers in zip 55114 |
Taxonomy Code | 163WP0809X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Psych/Mental Health, Adult |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073095063 | Taylor Ohotto | Registered Nurse | 644 Willoughby Way W, Hopkins, MN 55305-5352 | 2018-09-05 |
1043650534 | William Clare Cebulla | Registered Nurse | 29538 Olinda Trl, Lindstrom, MN 55045-9440 | 2013-06-27 |
1851638159 | Mary Kay Borgstrom | Registered Nurse | 905 Forest Ave E Ste 150, Mora, MN 55051-1632 | 2013-01-08 |
1780951103 | Helen Margaret Knox | Registered Nurse | Hennepin County Government Center A14, 300 So 6th St, Minneapolis, MN 55487-0001 | 2011-11-30 |
1023229085 | Patricia K. Cretilli | Registered Nurse | 5430 Edgewater Blvd, Minneapolis, MN 55417-2604 | 2007-05-24 |
1093862732 | April Leta Wolfson | Registered Nurse | 327 Marschall Rd # 350, Shakopee, MN 55379-1687 | 2007-01-04 |
1992716245 | Cheryl A. Covert | Registered Nurse | 1044 Saint Johns Bay, Woodbury, MN 55129-8537 | 2006-08-11 |
1730164567 | Kathleen J Lietzau | Registered Nurse | 6950 146th St W, Suite 100, Apple Valley, MN 55124-4513 | 2005-12-14 |
1255777322 | Sandra Jean Shadley | Registered Nurse | 225 Sherburne St N, Stillwater, MN 55082-4726 | 2013-05-16 |
1134497399 | Barbara Ann Erickson | Registered Nurse | 300 S 6th St, Government Center A1400, Minneapolis, MN 55487-0999 | 2011-12-02 |
Find all providers with the same taxonomy |
City | SAINT PAUL |
Zip Code | 55114 |
Please comment or provide details below to improve the information on KATHLEEN ELIZABETH PENGELLY.
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.