Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1619985553

Unknown Individual is a healthcare provider. based in Andover, Minnesota. specializing in Certified Registered Nurse Anesthetist. They hold a License No. R0938910 (MN). The NPI Number for Unknown Individual is 1619985553

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1619985553
Phone
(763) 754-3535
Address
2746 133RD LN NW
Deactivation Date
4 November 2021
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

  • 2746, 133rd Lane Northwest, Andover, Anoka County, Minnesota, 55304, United States

    ANDOVER, MN 553043810

    Phone: (763) 754-3535

    Fax: (763) 754-3535

    Type: Mailing

  • North Memorial Medical Center, 3300, Oakdale Avenue North, Robbinsdale, Hennepin County, Minnesota, 55422, United States

    NORTH MEMORIAL MEDICAL CENTER

    ROBBINSDALE, MN 554222926

    Phone: (763) 520-5200

    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.

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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.

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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 55304)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1619985553?
NPI 1619985553 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Andover?
Public fields place Unknown Individual around Andover, Minnesota. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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