KATHLEEN ELIZABETH PENGELLY


Address: 762 Transfer Rd Ste 21, Saint Paul, MN 55114-1489
Phone: 6516592900

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).

Provider Overview

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

Taxonomy

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

Provider Secondary Practice Location

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

Office Location

Street Address 762 TRANSFER RD STE 21
City SAINT PAUL
State MN
Zip Code 55114-1489

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 163WP0809X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Psych/Mental Health, Adult

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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
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Competitor

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City SAINT PAUL
Zip Code 55114

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Dataset Information

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.

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