| Psych North Pllc | |
|
1003 E Central Entrance Duluth MN 55811-5501 | |
| (218) 209-2150 | |
| (833) 903-0315 |
| Full Name | Psych North Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1003 E Central Entrance, Duluth, Minnesota |
| Authorized Official Name and Position | Patrick Bailey (CO-OWNER) |
| Authorized Official Contact | 2182092150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psych North Pllc 2854 Highway 55 Ste 130 Eagan MN 55121-1776 Ph: (651) 842-3349 | Psych North Pllc 1003 E Central Entrance Duluth MN 55811-5501 Ph: (218) 209-2150 |
| NPI Number | 1760136964 |
|---|---|
| Provider Enumeration Date | 02/07/2022 |
| Last Update Date | 08/25/2023 |
| Certification Date | 08/25/2023 |
| Medicare PECOS PAC ID | 9537546841 |
|---|---|
| Medicare Enrollment ID | O20220506000115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760136964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Patrick A Bailey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194749267 PECOS PAC ID: 0648165852 Enrollment ID: I20040217000774 |
| Provider Name | Sujit R Varma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013018258 PECOS PAC ID: 0840224002 Enrollment ID: I20050927000227 |
| Provider Name | Natalie N Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1174763528 PECOS PAC ID: 4880743947 Enrollment ID: I20090519000644 |
| Provider Name | Krista L Mcmanus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578948428 PECOS PAC ID: 6103136726 Enrollment ID: I20151112000178 |
| Provider Name | Natalie N Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174763528 PECOS PAC ID: 4880743947 Enrollment ID: I20230417000698 |
| Provider Name | Amy Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386216547 PECOS PAC ID: 1254787179 Enrollment ID: I20231030002050 |
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