Unknown Individual – Obstetrics & Gynecology Nurse Practitioner, NPI 1629069588

Unknown Individual is a healthcare provider. based in Saint cloud, Minnesota. specializing in Obstetrics & Gynecology Nurse Practitioner. They hold a License No. R 081665 0 (MN). The NPI Number for Unknown Individual is 1629069588

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1629069588
Phone
(320) 654-3630
Address
1900 CENTRACARE CIR
Deactivation Date
9 December 2020
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

  • 1900, Centracare Circle, Shady Oak Mobile Park, St. Cloud, Stearns County, Minnesota, 56303, United States

    SAINT CLOUD, MN 563035000

    Phone: (320) 654-3630

    Fax: (320) 654-3657

    Mailing address matches the actual address.

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.

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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 56303)

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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 1629069588.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Obstetrics & Gynecology Nurse Practitioner is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Saint Cloud, Minnesota in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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