MICHAEL GLENN PETTY RN ACNS-BC CCNS NPI 1255951216

NPI Information

NPI: 1255951216
Provider Name: MICHAEL GLENN PETTY, RN, ACNS-BC, CCNS
Classification: Clinical Nurse Specialist - 364SA2200X
Entity Type: Individual

Specialization: Adult Health

Address:
500 HARVARD ST SE
MINNEAPOLIS, MN
ZIP 55455
Phone: (612) 273-5607
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Michael Glenn Petty, RN, ACNS-BC, CCNS is an adult health clinical nurse specialist in Minneapolis, MN. Michael Glenn Petty, RN, ACNS-BC, CCNS NPI is 1255951216. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

500 HARVARD ST SE
MINNEAPOLIS, MN
ZIP 55455-363
Phone: (612) 273-5607
Fax: (612) 273-9966

The enumeration date for this NPI number is 4/20/2020 and was last updated on 4/20/2020.

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	163WC0200X	Registered Nurse	Critical Care Medicine	095570	MINNESOTA	No
2	364SA2200X	Clinical Nurse Specialist	Adult Health	71	MINNESOTA	Yes
3	364SC0200X	Clinical Nurse Specialist	Critical Care Medicine	71	MINNESOTA	No

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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