SHELLEY A BRATHOLDT (NPI# 1699749630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699749630 |
| Entity Type | Individual |
| Full Name | SHELLEY A BRATHOLDT |
| Credential | ANP |
| Practice Address |
205 S Wabasha St Healthpartners St. Paul Urgent Care St. Paul MN 55107-1805 |
| Mailing Address |
8170 33rd Ave S Ms21110q Minneapolis MN 55425-4516 |
| Practice Telephone | 9528538800 |
| Practice Fax Number | 6512938106 |
| Mailing Telephone | 9528835375 |
| Mailing Fax Number | 6512938106 |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2012-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 65387 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 963219100 | 05 |
| Street Address |
205 S WABASHA ST HEALTHPARTNERS ST. PAUL URGENT CARE |
| City | ST. PAUL |
| State | MN |
| Zip Code | 55107-1805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982688016 | Vathsala Ganeshan | Pediatrics | 205 S Wabasha St, Mail Stop 31300a - Healthpartners St. Paul Clinic, St. Paul, MN 55107-1805 | 2005-12-02 |
| 1164734976 | John R Grittner | Dentist | 205 S Wabasha St, St. Paul, MN 55107-1805 | 2010-07-09 |
| 1134394182 | Patrick S Inveen | Family Medicine | 205 S Wabasha St, Mail Stop 31300a - Healthpartners St. Paul Clinic, St. Paul, MN 55107-1805 | 2008-04-29 |
| 1861676025 | Venkata S Vundamati | Family Medicine | 205 S Wabasha St, Mail Stop 31300a - Healthpartners St. Paul Clinic, St. Paul, MN 55107-1805 | 2007-12-24 |
| 1073568093 | Asima Yasin | Family Medicine | 205 S Wabasha St, Healthpartners St. Paul Clinic - Mail Stop 31300a, St. Paul, MN 55107-1805 | 2006-05-24 |
| 1265484679 | Michelle E Tomes | Family Medicine | 205 S Wabasha St, Mail Stop 31300a - Healthpartners St. Paul Clinic, St. Paul, MN 55107-1805 | 2006-05-16 |
| 1194785279 | Ralph S Bovard | Preventive Medicine | 205 S Wabasha St, Mail Stop 31300a Healthpartners St. Paul Clinic, St. Paul, MN 55107-1805 | 2006-03-24 |
| 1023077658 | Bruce M Johnson | Internal Medicine | 205 S Wabasha St, Healthpartners St. Paul Clinic - Mail Stop 31300a, St. Paul, MN 55107-1805 | 2006-03-22 |
| 1104894260 | Robert N Koch | Internal Medicine | 205 S Wabasha St, Healthpartners St. Paul Clinic - Mail Stop 31300a, St. Paul, MN 55107-1805 | 2006-03-14 |
| 1609844992 | Roger J Cornetto | Internal Medicine | 205 S Wabasha St, Healthpartners St. Paul Clinic - Mail Stop 31300a, St. Paul, MN 55107-1805 | 2006-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477944809 | Marina Castillo | Counselor | 143 Isabel St. W, Saint Paul, MN 55107 | 2015-02-06 |
| 1134540123 | Michelle M Lee | Social Worker | 106 Water Street/3rd Floor, Umbrella Tree Studios, St. Paul, MN 55107 | 2013-12-18 |
| 1376748574 | Mary E. A. Horoshak | Physical Therapist | 155 S Wabasha St, Suite 130, St. Paul, MN 55107 | 2007-06-18 |
| 1821156050 | Amherst H. Wilder Foundation | Assisted Living Facility | 469 Ada St, Saint Paul, MN 55107 | 2006-12-04 |
| 1407914674 | Amherst H. Wilder Foundation | Clinic/Center | 516 Humboldt Ave, Saint Paul, MN 55107 | 2006-12-04 |
| 1780753681 | Chad Randal Vickers | Nurse Practitioner | 135 Colorado Street East, Saint Paul, MN 55107 | 2006-11-06 |
| 1225122872 | Elizabeth E Frost | Family Medicine | 153 Cesar Chavez Street, St Paul, MN 55107 | 2006-10-03 |
| 1215457890 | Elizabeth Smith Zaremba | Dietitian, Registered | 205 Wabasha St S, Mail Stop 31300a, St Paul, MN 55107 | 2017-06-23 |
| 1619413606 | Elizabeth Burgos | Social Worker | 153 Cesar Chavez St, Saint Paul, MN 55107 | 2017-01-13 |
| 1033561915 | Isetta Pierre | Marriage & Family Therapist | 153 Cesar Chavez St, Saint Paul, MN 55107 | 2016-07-05 |
| Find all providers in zip 55107 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225348824 | Amanda K Keogh | Nurse Practitioner | 255 No Smith Ave #100, St. Paul, MN 55102 | 2010-10-15 |
| 1255583449 | Suzanne Elizabeth Trunnell | Nurse Practitioner | 1020 Bandana Blvd. W, Aspen Medical Group--bandana Square, St. Paul, MN 55108 | 2008-10-21 |
| 1811002264 | Glenda Jean Morris | Nurse Practitioner | 45 West 10th Street, St. Paul, MN 55102 | 2006-08-19 |
| 1427026426 | Jennifer M Johnson | Nurse Practitioner | 640 Jackson St - Mc11108b, Healthpartners Regions Specialty Clinics, St. Paul, MN 55101-2502 | 2006-03-08 |
| 1962474015 | Mary J Schwanke | Nurse Practitioner | 451 North Dunlap St - Mail Stop 32700a, Healthpartners Midway Clinic, St. Paul, MN 55104-4621 | 2006-02-03 |
| 1134499783 | Heather Ann Naylor | Nurse Practitioner | 200 University Ave E, St. Paul, MN 55101-9023 | 2012-01-12 |
| 1659542835 | Anna Maria Napiwocki | Nurse Practitioner | 345 North Smith Avenue, Children's Health Care, St. Paul, MN 55102-2346 | 2008-03-17 |
| 1841477650 | Lori A Ranney | Nurse Practitioner | 347 North Smith Avenue, St. Paul, MN 55102-2346 | 2008-01-23 |
| 1538202759 | Jana M Ostrand | Nurse Practitioner | 401 Phalen Boulevard, St. Paul, MN 55130-5302 | 2007-02-15 |
| 1184698557 | Judith A Wulf | Nurse Practitioner | 401 Phalen Boulevard, St. Paul, MN 55130-5302 | 2006-02-14 |
| Find all providers in ST. PAUL | ||||
Please comment or provide details below to improve the information on SHELLEY A BRATHOLDT.
| 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.