CRETILLI AND ASSOCIATES, PA (NPI# 1376873331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376873331 |
Entity Type | Organization |
Organization Name | CRETILLI AND ASSOCIATES, PA |
Practice Address |
5430 Edgewater Blvd Minneapolis MN 55417-2604 |
Practice Telephone | 6128222714 |
Mailing Telephone | 6128222714 |
Enumeration Date | 2010-01-13 |
Last Update Date | 2010-01-13 |
Authorized Official Name | DR. PATRICIA K CRETILLI (PRESIDENT) |
Authorized Official Telephone | 6128222714 |
Authorized Official Credential | RN, CNS, PHD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | BLUE CROSS BLUE SHIELD OF MINNESOTA | 77D30CR | 01 |
Street Address |
5430 EDGEWATER BLVD |
City | MINNEAPOLIS |
State | MN |
Zip Code | 55417-2604 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023229085 | Patricia K. Cretilli | Registered Nurse | 5430 Edgewater Blvd, Minneapolis, MN 55417-2604 | 2007-05-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205444791 | Patrick Reilly Steck | Dentist | 4948 S 34th Ave, Minneapolis, MN 55417 | 2020-07-21 |
1174160832 | Susan Jacobson | Pharmacist | One Veterans Drive (119), Minneapolis, MN 55417 | 2019-12-02 |
1699240580 | Angela Cox | Social Worker | Vamc Minneapolis, 1 Veterans Drive (1k), Minneapolis, MN 55417 | 2018-10-08 |
1407353519 | Kirsten Kathleen Rydberg | Registered Nurse | One Veteran Drive, Minneapolis, MN 55417 | 2018-04-06 |
1902306038 | Ksa Psychological Services, LLC | Psychologist | 5603 Chicago Ave., Minneapolis, MN 55417 | 2018-02-15 |
1770025710 | Elizabeth Kate Adam | Registered Nurse | 613 E Minnehaha Pkwy, Minneapolis, MN 55417 | 2016-11-08 |
1831579754 | John Rossakis | Occupational Therapist | 5708 42nd Ave S, Minneapolis, MN 55417 | 2015-06-05 |
1205214566 | Karin Shelstad | Specialist/Technologist | 5501 10th Av S, Minneapolis, MN 55417 | 2015-05-07 |
1750712733 | Debra Sand | Massage Therapist | 2750 E 50th Street, Minneapolis, MN 55417 | 2013-12-02 |
1669764221 | Michael Alan Newman | Internal Medicine | One Veterans Drive (111-0), Minneapolis Veterans Affairs Medical Center, Minneapolis, MN 55417 | 2011-05-13 |
Find all providers in zip 55417 |
Taxonomy Code | 364SP0809X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Psych/Mental Health, Adult |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285725291 | Kimberly M Wolf | Clinical Nurse Specialist | 701 Park Ave # O8, Minneapolis, MN 55415-1623 | 2006-09-27 |
1194049585 | Elaine Hope Darst | Clinical Nurse Specialist | 615 1st Ave Ne, Suite 310, Minneapolis, MN 55413-2447 | 2010-03-15 |
1356671010 | Vicki Jo Dean-gramlich | Clinical Nurse Specialist | 701 Park Ave, Minneapolis, MN 55415-1623 | 2009-12-31 |
1134371321 | Jennifer Marie Wolfe | Clinical Nurse Specialist | 3100 W Lake St, Suite 210, Minneapolis, MN 55416-4527 | 2008-10-21 |
1215151402 | Merrie Jean Kaas | Clinical Nurse Specialist | 615 1st Ave Ne, Suite 310, Minneapolis, MN 55413-2447 | 2007-04-12 |
1104947241 | Louise Marie Mcnamara | Clinical Nurse Specialist | 615 1st Ave Ne, Suite 310, Minneapolis, MN 55413-2447 | 2007-04-03 |
1588780068 | Marlene Grace Buskirk | Clinical Nurse Specialist | 615 1st Ave Ne, Suite 310, Minneapolis, MN 55413-2447 | 2007-03-22 |
1811098486 | Renee Diane Koemptgen | Clinical Nurse Specialist | 701 Park Ave, Minneapolis, MN 55415-1623 | 2006-09-26 |
1184724056 | Lori Kay Baier | Clinical Nurse Specialist | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2006-09-22 |
1700984770 | Denise Dehn Farr | Clinical Nurse Specialist | 1 Veterans Dr, Route 116a, Minneapolis, MN 55417-2309 | 2006-09-21 |
Find all providers in MINNEAPOLIS |
City | MINNEAPOLIS |
Zip Code | 55417 |
Please comment or provide details below to improve the information on CRETILLI AND ASSOCIATES, PA.
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.