Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1033214655

Unknown Individual is a healthcare provider. based in Lake elmo, Minnesota. specializing in Certified Registered Nurse Anesthetist. They hold a License No. R0788843 (MN). The NPI Number for Unknown Individual is 1033214655

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1033214655
Phone
(651) 251-8021
Address
8681 EAGLE POINT BLVD
Deactivation Date
12 December 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Eagle Point Boulevard, Lake Elmo, Washington County, Minnesota, 55125, United States

    LAKE ELMO, MN 550428628

    Phone: (651) 251-8021

    Fax: (651) 251-8050

    Type: Mailing

  • Woodwinds Health Campus, 1925, Woodwinds Drive, Woodbury, Washington County, Minnesota, 55125, United States

    WOODBURY, MN 551252270

    Phone: (651) 735-0501

    Fax: (651) 735-1870

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55042)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1033214655.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Certified Registered Nurse Anesthetist in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Lake Elmo, Minnesota may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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