ELLISE CAROLINE BRAVEHEART RN CNP FNP-C NPI 1275930026

NPI Information

  • NPI: 1275930026
  • Provider Name: ELLISE CAROLINE BRAVEHEART, RN, CNP, FNP-C
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 927 TRETTEL LN
    CLOQUET, MN
    ZIP 55720
  • Phone: (218) 879-1227

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NPI Details

Ellise Caroline Braveheart, RN, CNP, FNP-C is a family nurse practitioner in Cloquet, MN with 3 years of experience. Ellise Caroline Braveheart, RN, CNP, FNP-C NPI is 1275930026. 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:

927 TRETTEL LN
CLOQUET, MN
ZIP 55720-345
Phone: (218) 879-1227

The NPI 1275930026 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 11/21/2014 and was last updated on 1/3/2023.

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
1163WM0705XRegistered NurseMedical-SurgicalR221785-9MINNESOTANo
2363LF0000XNurse PractitionerFamily9590MINNESOTAYes

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: 3/30/2025

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