CORALIE ANN PEDERSON


Address: 410 Church St Se, Minneapolis, MN 55455-0222
Phone: 6126257900

CORALIE ANN PEDERSON (NPI# 1841283074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1841283074
Entity Type Individual
Full Name CORALIE ANN PEDERSON
Credential WHNP
Practice Address 410 Church St Se
Minneapolis
MN 55455-0222
Mailing Address 1619 Dayton Ave
St Paul
MN 55104
Practice Telephone 6126257900
Practice Fax Number 6516422523
Mailing Telephone (651) 645-0478
Mailing Fax Number 6516422523
Enumeration Date 2005-08-23
Last Update Date 2017-09-27
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner R131630-8 MN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN 463972300 05

Office Location

Street Address 410 CHURCH ST SE
City MINNEAPOLIS
State MN
Zip Code 55455-0222

Providers in the same location

NPI Name Taxonomy Address Enumeration
1073155438 Chee Her Social Worker 410 Church St Se, Minneapolis, MN 55455-0222 2019-10-16
1447802236 Seth Christman Psychologist 410 Church St Se, Minneapolis, MN 55455-0222 2019-07-11
1689230450 Nicholas Edward Peterson Physical Medicine & Rehabilitation 410 Church St Se, Minneapolis, MN 55455-0222 2019-05-16
1073085718 Cassandra Patricia Price Social Worker 410 Church St Se, Minneapolis, MN 55455-0222 2018-12-19
1912475450 Jennifer Arnold Physical Therapist 410 Church St Se, Minneapolis, MN 55455-0222 2018-11-02
1033686480 Emily Rischall Price Psychologist 410 Church St Se, Minneapolis, MN 55455-0222 2018-10-24
1790262707 Hannah Marie Serwe Social Worker 410 Church St Se, Minneapolis, MN 55455-0222 2018-07-23
1861908261 Ann Zedginidze Counselor 410 Church St Se, Minneapolis, MN 55455-0222 2017-12-20
1972021368 Dominic Poulin Counselor 410 Church St Se, Minneapolis, MN 55455 2017-09-06
1487175253 Ben Andrew Mattson Counselor 410 Church St Se, Minneapolis, MN 55455-0222 2017-07-03
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1841803970 Kelsey Olson Nurse Practitioner 2450 Riverside Ave Fl 9, Minneapolis, MN 55454-1450 2020-08-28
1396373932 Hayley Starr Gifford Nurse Practitioner 33 105th Ave Nw, Minneapolis, MN 55448-5044 2020-03-30
1225535701 Karissa Dougherty Nurse Practitioner 2200 E Franklin Ave # 199, Minneapolis, MN 55404 2018-04-10
1831646108 Ingrid Estephan Nurse Practitioner 2929 21st Ave S Apt 301, Minneapolis, MN 55407-4515 2016-09-05
1730532631 Allina Health System Nurse Practitioner 913 E 26th St Ste 305, Minneapolis, MN 55404-4515 2016-07-15
1619376860 Amy Cooley Nurse Practitioner 800 E 28th St # H2100, Minneapolis, MN 55407 2014-08-13
1710265368 Kimberly Dawn Moore Nurse Practitioner 814 South 3rd Street, Minneapolis, MN 55415 2011-08-01
1164700878 Katherine Casey Martin Caughel Nurse Practitioner Hcmc, 701 Park Ave, Surgery Department, P-5, Minneapolis, MN 55415-1623 2011-07-29
1386951358 Jody Michelle Schoenecker Nurse Practitioner 615 1st Ave Ne Ste 310, Minneapolis, MN 55413-2419 2010-09-10
1043543093 Therese Mary Maas Nurse Practitioner 909 Fulton St Se Ste 300, Minneapolis, MN 55455 2009-09-09
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Competitor

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City MINNEAPOLIS
Zip Code 55455

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Dataset Information

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.

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