ANNIKA LEE BLAINE NPI 1699253468

NPI Information

NPI: 1699253468
Provider Name: ANNIKA LEE BLAINE
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
1700 UNIVERSITY AVE W
SAINT PAUL, MN
ZIP 55104
Phone: (612) 232-2002
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Annika Lee Blaine is a gerontology nurse practitioner in Saint Paul, MN. Annika Lee Blaine NPI is 1699253468. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1700 UNIVERSITY AVE W
SAINT PAUL, MN
ZIP 55104-727
Phone: (612) 232-2002

The NPI 1699253468 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/2/2018 and was last updated on 11/25/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		1991914	MINNESOTA	No
2	363LA2200X	Nurse Practitioner	Adult Health	6070	MINNESOTA	No
3	363LG0600X	Nurse Practitioner	Gerontology	6070	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1991914	OTHER	MINNESOTA	RN LICENSE
2	241607	OTHER	WISCONSIN	RN LICENSE
3	6070	OTHER	MINNESOTA	CERTIFIED NURSE PRACTITIONER LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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