DR. PENNIE ELIZABETH BUCILLA (NPI# 1104225499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104225499 |
| Entity Type | Individual |
| Full Name | DR. PENNIE ELIZABETH BUCILLA |
| Credential | APRN CNP |
| Practice Address |
1500 Mcandrews Rd W Burnsville MN 55337 |
| Practice Telephone | 9528929393 |
| Practice Fax Number | 9528008892 |
| Mailing Telephone | 9528929393 |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2020-09-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R156407-9 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R156407-9 CNP197 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MINNESOTA HEALTH CARE PROGRAMS (MHCP) | 1104225499 | 01 |
| Street Address |
1500 MCANDREWS RD W |
| City | BURNSVILLE |
| State | MN |
| Zip Code | 55337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669464905 | John Mark Prichard | Psychologist | 1500 Mcandrews Rd W, Suite 209, Burnsville, MN 55337-4432 | 2005-08-22 |
| 1457718041 | Brian Zirngible, LLC | Community/Behavioral Health | 1500 Mcandrews Rd W, Burnsville, MN 55337-4432 | 2016-01-27 |
| 1235533738 | Claire Kaehr | Marriage & Family Therapist | 1500 Mcandrews Rd W, Suite 231, Burnsville, MN 55337-4432 | 2014-10-14 |
| 1750794350 | Many Sparrows LLC | Marriage & Family Therapist | 1500 Mcandrews Rd W, Burnsville, MN 55337-4432 | 2014-06-11 |
| 1023449022 | Tkmn, LLC | Home Health | 1500 Mcandrews Rd W, Suite 218, Burnsville, MN 55337-4432 | 2013-12-02 |
| 1265864318 | Julie Ann Temmel-friesen | Marriage & Family Therapist | 1500 Mcandrews Rd W, Suite 201, Burnsville, MN 55337-4432 | 2013-07-31 |
| 1386954386 | Kelly Dial | Marriage & Family Therapist | 1500 Mcandrews Rd W, Suite 215, Burnsville, MN 55337-4432 | 2010-10-12 |
| 1790009884 | Kristi Lynn Wilder | Marriage & Family Therapist | 1500 Mcandrews Rd W, Ste 201, Burnsville, MN 55337-4432 | 2010-03-18 |
| 1982841748 | Full Circle Therapy | Counselor | 1500 Mcandrews Rd W, Suite 230, Burnsville, MN 55337-4432 | 2009-01-15 |
| 1447434279 | Debbie Carol Janiga Scheide | Marriage & Family Therapist | 1500 Mcandrews Rd W, Suite 229, Burnsville, MN 55337-4432 | 2007-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053939397 | Alpha Quality Care1 L. L. C. | Home Infusion | 12924 18th Ave South, Burnsville, MN 55337 | 2020-07-13 |
| 1568085900 | Kathryn Harris | Counselor | 11939 W. River Hills Dr., Burnsville, MN 55337 | 2020-05-20 |
| 1952941254 | Noah Home Care Inc. | Home Health | 13521 Nicollet Lane, Burnsville, MN 55337 | 2020-01-14 |
| 1750854287 | Baraka Home Care LLC | Nursing Care | 1700 James Place, Burnsville, MN 55337 | 2019-01-08 |
| 1699298778 | Raphael Cheron-dittmann | Hearing Instrument Specialist | 14000 Nicollet Ave. S., Suite 303, Burnsville, MN 55337 | 2017-07-20 |
| 1669909818 | Mercy Home Care Ltd | Hospice Care, Community Based | 1020 E 146th St Ste 220d, Burnsville, MN 55337 | 2017-05-18 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1730542572 | Iris Reproductive Psychiatric Clinic | Clinical Nurse Specialist | 1500 Mcandrews Road W, Ste 227, Burnsville, MN 55337 | 2016-03-30 |
| 1740657204 | Mercy Link, LLC | Home Health | 13005 Salem Pl, Burnsville, MN 55337 | 2015-08-31 |
| 1669852158 | Mixa Dipak Patel | Physical Therapy Assistant | 8380 Hiawatha Ave, Eden Prairie, MN 55337 | 2015-06-01 |
| Find all providers in zip 55337 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245719749 | Strata Psychiatry Pllc | Nurse Practitioner | 200 E Travelers Trl Ste 205, Burnsville, MN 55337-4191 | 2018-08-07 |
| 1669715421 | Amanda Lynn Schuh | Nurse Practitioner | 303 E Nicollet Blvd, Suite 200, Burnsville, MN 55337-4522 | 2013-03-30 |
| 1639423544 | Pamela Brown | Nurse Practitioner | 14551 Judicial Rd Ste 100, Burnsville, MN 55306-4991 | 2012-10-30 |
| 1669590485 | Maren Schiess Rinker | Nurse Practitioner | 200 E Travelers Trl, #225, Burnsville, MN 55337-4097 | 2007-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234435 | Hawa Warsame Ali | Nurse Practitioner | 2650 Portland Ave, Minneapolis, MN 55407-1011 | 2020-10-27 |
| 1962009548 | Emily Ongaga | Nurse Practitioner | 43 10 Parkview Circle, Anoka, MN 55303 | 2020-10-06 |
| 1811504038 | Rita Jane Giglio | Nurse Practitioner | 201 Stade Ln, Fairmont, MN 56031-3227 | 2020-09-30 |
| 1568077725 | Linda Mongare | Nurse Practitioner | 3659 Tower Pond Dr, Anoka, MN 55303-8302 | 2020-09-14 |
| 1366056806 | Associates In Mental Health and Addiction Services. P.l.l.c | Nurse Practitioner | 166 W 3rd St Ste 202, Winona, MN 55987-6591 | 2020-09-02 |
| 1891308813 | Chelsey Paulson | Nurse Practitioner | 228 Krays Mill Rd, Cold Spring, MN 56320-4563 | 2020-08-28 |
| 1417560681 | Amy Engle | Nurse Practitioner | 1125 Se 8th Street, Willmar, MN 56201 | 2020-08-28 |
| 1609488964 | Heather Mantsch | Nurse Practitioner | 1900 Silver Lake Rd Nw Ste 100, New Brighton, MN 55112-1786 | 2020-08-18 |
| 1326659210 | Monsurat Oluwa-okougbo | Nurse Practitioner | 1565 11th Ave, Newport, MN 55055-1650 | 2020-08-13 |
| 1629687124 | Justin Robert Wirth | Nurse Practitioner | 4801 Veterans Dr # 111, Saint Cloud, MN 56303-2015 | 2020-07-30 |
| Find all providers with the same taxonomy | ||||
| City | BURNSVILLE |
| Zip Code | 55337 |
Please comment or provide details below to improve the information on DR. PENNIE ELIZABETH BUCILLA.
| 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.