BRYAN KAVANAUGH
NPI 1033415716
Registered Nurse - Pediatrics in Roseville, MN
About Bryan Kavanaugh NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRYAN KAVANAUGH (NPI 1033415716) is an individual pediatrics provider in Roseville, Minnesota, licensed in Minnesota (R191548-2) and active in the NPI registry since January 2011.
NPPES Registry Identity
Specialties & Licenses
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Bryan Kavanaugh's NPI number?
The NPI number for Bryan Kavanaugh is 1033415716. It was assigned to this individual provider in the NPPES registry on January 28, 2011.
Where is Bryan Kavanaugh located?
Bryan Kavanaugh practices at 2800 Cleveland Ave N, Roseville, MN 55113. The listed phone number is (651) 642-1825.
What is Bryan Kavanaugh's specialty?
The primary specialty registered for this NPI is Registered Nurse, specializing in Pediatrics, with taxonomy code 163WP0200X.
When was this NPI record last updated?
The NPPES record for Bryan Kavanaugh was last updated on January 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Bryan Kavanaugh · NPI 1033415716
Pediatrics provider in Roseville, Minnesota. Individual provider, active in the CMS NPPES registry since January 28, 2011.
## Identity
- **NPI:** 1033415716 (Entity type: Individual)
- **Enumerated:** January 28, 2011
- **Primary specialty:** Registered Nurse - Pediatrics · taxonomy 163WP0200X
- **State license:** R191548-2 (Minnesota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2800 CLEVELAND AVE N, Roseville, MN 55113-1126
- **Phone:** (651) 642-1825
## Record status
- **NPPES last updated:** January 28, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1033415716) · Data from the CMS NPPES public registry.