MICHAEL GLENN PETTY (NPI# 1255951216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255951216 |
| Entity Type | Individual |
| Full Name | MICHAEL GLENN PETTY |
| Credential | RN, ACNS-BC, CCNS |
| Practice Address |
500 Harvard St Se Minneapolis MN 55455-0363 |
| Mailing Address |
7615 Xerxes Ave S Richfield MN 55423-3546 |
| Practice Telephone | 6122735607 |
| Practice Fax Number | 6122739966 |
| Mailing Telephone | 6122735607 |
| Mailing Fax Number | 6122739966 |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2020-04-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC0200X |
Registered Nurse Specialization: Critical Care Medicine |
095570 | MN | Nursing Service Providers |
| Y | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
71 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SC0200X |
Clinical Nurse Specialist Specialization: Critical Care Medicine |
71 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679578132 | Michael Travis Petty | Chiropractor | 10826 Kingston Pike, Knoxville, TN 37934-3059 | 2005-06-20 |
| 1598222531 | Michael Petty | Physical Therapist | 22 Mill St Ste 406, Arlington, MA 02476-4744 | 2019-02-26 |
| 1013355817 | Michael Duane Petty | Nurse Anesthetist, Certified Registered | 101 W 8th Ave, Mother Gamelin Center 3rd Floor, Spokane, WA 99204-2307 | 2013-06-13 |
| 1700850682 | Michael Kent Petty | Family Medicine | 7300 Bosque Blvd, Waco, TX 76710 | 2006-02-15 |
| Street Address |
500 HARVARD ST SE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55455-0363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396737359 | Tae Whang Kim | Anesthesiology | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2005-08-16 |
| 1972100923 | Laura Eggen | Nurse Practitioner | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2020-10-02 |
| 1720695448 | Natalie Jean Olson | Nurse Anesthetist, Certified Registered | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2020-09-27 |
| 1316551518 | Zachary Taylor | Registered Nurse | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2020-09-04 |
| 1346852969 | Lane M Skalberg | Pharmacist | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2020-08-17 |
| 1801407192 | Vicky Hedican-sime | Nurse Practitioner | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2020-08-11 |
| 1356967293 | Rachel Saefong | Occupational Therapist | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2020-06-16 |
| 1467073288 | Shamsah Rehmatullah | Clinical Nurse Specialist | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2020-05-04 |
| 1801417142 | Megan Bergland | Occupational Therapist | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2020-04-28 |
| 1144849985 | Jesse Bach | Nurse Practitioner | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2020-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932715679 | Kara Biscobing | Nurse Anesthetist, Certified Registered | M Health Fairview Ummc East Bank 3-307, 500 Harvard Street, Minneapolis, MN 55455 | 2020-09-18 |
| 1982213237 | Yue Hu | Dentist | 515 Delaware St. Se Malcolm Moos Health Sciences Tower, Room 7-174, Minneapolis, MN 55455 | 2020-07-23 |
| 1952922148 | Jacob Laurence Tigner | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se, Mmc 284, Minneapolis, MN 55455 | 2020-04-29 |
| 1710507538 | Rachael Grundman | Student in an Organized Health Care Education/Training Program | 420 Delaware St, Mmc 395, Minneapolis, MN 55455 | 2020-04-22 |
| 1497375240 | Sanjay Dhawan | Student in an Organized Health Care Education/Training Program | 420 Delaware St. Se, Mmc 195, Minneapolis, MN 55455 | 2020-04-22 |
| 1508486549 | Dariel Andres Diaz | Student in an Organized Health Care Education/Training Program | 420 Se Delaware Street, Mmc 195, Minneapolis, MN 55455 | 2020-04-20 |
| 1275186280 | Kerem Ozturk | Radiology | B-226 Mayo Memorial Building, Mmc 292 420 Delaware Street S.e., Minneapolis, MN 55455 | 2019-07-18 |
| 1275194631 | Andres Jose Gonzalez Coba | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se Mmc 284, Minneapolis, MN 55455 | 2019-06-26 |
| 1841850278 | Brendan Andrew Schleyer | Dentist | 515 Delaware St Se, Div of Periodontology, Moos Tower, 7-368, Minneapolis, MN 55455 | 2019-06-18 |
| 1932767399 | Claire-audrey Y Bayan | Student in an Organized Health Care Education/Training Program | 420 Delaware Street, Mmc 98, Minneapolis, MN 55455 | 2019-05-31 |
| Find all providers in zip 55455 | ||||
| Taxonomy Code | 364SA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336186048 | Kelli J Simmons | Clinical Nurse Specialist | 420 Delaware Street Southeast, Mayo Mail Code 450, Minneapolis, MN 55455 | 2006-06-01 |
| 1710312087 | Denise Casamento Musser | Clinical Nurse Specialist | 424 Harvard St Se, Minneapolis, MN 55455-0362 | 2013-09-05 |
| 1780017020 | Yeewan Sum Kao | Clinical Nurse Specialist | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2013-08-09 |
| 1881932267 | Autumn Gode | Clinical Nurse Specialist | 800 E 28th St, Minneapolis, MN 55407-3723 | 2013-01-20 |
| 1477836054 | Sean Patrick Murray | Clinical Nurse Specialist | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2011-09-21 |
| 1447566963 | Christie Lee Frid | Clinical Nurse Specialist | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2010-08-21 |
| 1508098864 | Melinda Marie Hansen | Clinical Nurse Specialist | 2450 Riverside Ave, 6aw Palliative Care Team, Minneapolis, MN 55454-1450 | 2009-08-19 |
| 1629208079 | Jessica Jo Hampton | Clinical Nurse Specialist | 516 Delaware St Se, Clinic 6a, Minneapolis, MN 55455-0356 | 2009-07-20 |
| 1710156781 | Teri E. Kast | Clinical Nurse Specialist | 420 Delaware St Se, Mmc 200, Minneapolis, MN 55455-0341 | 2008-02-25 |
| 1770766651 | Elizabeth Jane Merkle | Clinical Nurse Specialist | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2007-12-13 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55455 |
Please comment or provide details below to improve the information on MICHAEL GLENN PETTY.
| 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.