MR. MICHAEL V DIMUCCI (NPI# 1083694806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083694806 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL V DIMUCCI |
| Credential | RN, MSN, FNP-C |
| Practice Address |
826 Trenton Ln N Minneapolis MN 55441-4496 |
| Practice Telephone | 6128058676 |
| Practice Fax Number | 2492015231 |
| Mailing Telephone | 6128058676 |
| Mailing Fax Number | 2492015231 |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2020-07-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R 112189-4 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 497460300 | 05 | |
| NAT'L REGISTRY PARAMEDIC | P0825227 | 01 | |
| MN | DEA NUMBER | MD0859415 | 01 |
| AANP BOARD CERTIFICATION | F0402042 | 01 | |
| MN | RN LICENSE | R1121894 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 840 Seasons Parkway, Healthpartners Quick Clinic, Woodbury, MN 55125 | 9528538800 | 6517025818 |
| Street Address |
826 TRENTON LN N |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55441-4496 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689190019 | The Recovery Clinic LLC | Clinic/Center | 9800 Shelard Pkwy Ste 215, Plymouth, MN 55441 | 2017-08-17 |
| 1356887186 | Katherine Marlow Bell | Dentist | 2805 Campus Dr Ste 245, Plymouth, MN 55441 | 2017-01-18 |
| 1083069538 | Mercade Waldon | Home Health Aide | 3501 Xenium Lane, Plymouth, MN 55441 | 2016-05-03 |
| 1346645538 | Phs Westhealth, Inc | Skilled Nursing Facility | 2775 Campus Drive North, Plymouth, MN 55441 | 2014-10-30 |
| 1427453125 | Samuel David Fine | Pharmacist | 4070 Goldenrod Ln, Plymouth, MN 55441 | 2014-10-24 |
| 1548672538 | Scott Aaron Schmidt | Dentist | 2720 Annapolis Circle N, Suite A, Plymouth, MN 55441 | 2014-05-23 |
| 1831498633 | Comforide Transportation Services LLC | Non-emergency Medical Transport (VAN) | 9730 37th Pl N Suite 201, Plymouth, MN 55441 | 2011-03-18 |
| 1255669271 | Tammy Kae Mehlhaus | Physician Assistant | 2855 Campus Drive, Suite 570, Plymouth, MN 55441 | 2009-12-02 |
| 1164758199 | Stephen P. Boger, Dds, Pa | Dentist | 2720 Annapolis Circle, Suite A, Plymouth, MN 55441 | 2009-10-27 |
| 1093908360 | Endodontic Professionals Pa Plymouth Endodontics | Dentist | 3401 Hwy 169 N, Plymouth, MN 55441 | 2007-08-21 |
| Find all providers in zip 55441 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639786312 | Peter Wahl | Nurse Practitioner | 4652 Lyndale Ave S, Minneapolis, MN 55419-5302 | 2020-09-28 |
| 1356951552 | Madelyn Jayne Argo | Nurse Practitioner | 1720 Victory Memorial Dr, Minneapolis, MN 55412-1239 | 2020-08-03 |
| 1356963789 | Kersten Larayne Bailey | Nurse Practitioner | 2958 Lincoln St Ne, Minneapolis, MN 55418-2236 | 2020-05-07 |
| 1649804519 | Ifrah Abdi Abdullahi | Nurse Practitioner | 620 E Franklin Ave Apt 413, Minneapolis, MN 55404-3293 | 2020-02-28 |
| 1821645342 | Kelsey Middlestaedt | Nurse Practitioner | 2525 Chicago Ave Ste 32-t5, Minneapolis, MN 55404-4518 | 2019-08-20 |
| 1720546773 | Erika Lindsey Kuis | Nurse Practitioner | 918 W Lake St, Minneapolis, MN 55408-2857 | 2019-03-08 |
| 1437639614 | Kelly Usitalo | Nurse Practitioner | 913 E 26th Street, Piper Building Suite 401, Minneapolis, MN 55407 | 2018-08-17 |
| 1588176028 | Sylvie Adjoko Gaba | Nurse Practitioner | 100 South Fifth Street 19th Floor, Minneapolis, MN 55402-5199 | 2017-10-24 |
| 1336664804 | Heidi M Morrisey | Nurse Practitioner | 800 East 28th St W, Minneapolis, MN 55407 | 2017-08-07 |
| 1275073181 | Yellow Coriander, Psc | Nurse Practitioner | 60 South 6th Street, Suite 2800, Minneapolis, MN 55402 | 2017-02-27 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55441 |
Please comment or provide details below to improve the information on MR. MICHAEL V DIMUCCI.
| 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.