Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

RESONANCEBRIDGE PSYCHIATRY & WELLNESS LLC
NPI 1639034770
Nurse Practitioner - Psychiatric/Mental Health in Maple Grove, MN

Q: What is Resonancebridge Psychiatry & Wellness LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since December 20, 2025

12682 88TH AVE N, MAPLE GROVE, MN 55369(612) 482-2034 Get Directions Write a Review

NPPES record last updated: September 1, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Sep 1, 2026, Jan 14, 2026, Jan 8, 2026 and 1 more (4 updates tracked since 2025).

On this page

About Resonancebridge Psychiatry & Wellness Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RESONANCEBRIDGE PSYCHIATRY & WELLNESS LLC (NPI 1639034770) is a healthcare organization registered as a psychiatric/mental health in Maple Grove, Minnesota and active in the NPI registry since December 2025. The organization maintains a secondary practice location in Lehi and lists Johnthap Obakpolor, Pmhnp, as its authorized official.

NPPES Registry Identity

NPI1639034770

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameRESONANCEBRIDGE PSYCHIATRY & WELLNESS LLC

Location Address12682 88TH AVE NMaple Grove, MN 55369-3044

Mailing Address12800 Whitewater Dr Ste 100Minnetonka, MN 55343-9347

Phone(612) 482-2034

Organization SubpartNo

Authorized OfficialJohnthap ObakpolorPmhnp · (612) 482-2034

Enumeration DateDecember 20, 2025

Last NPPES UpdateSeptember 1, 20264 updates tracked since enumeration

NPPES CertifiedSeptember 1, 2026

✔ NPI 1639034770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

12682 88TH AVE N, Maple Grove, MN 55369

Open in Google Maps ↗

Secondary Practice Location 1

Location 12901 W Blue Grass Blvd Ste 200Lehi, UT 84048-4190 · Phone (612) 482-2034

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Resonancebridge Psychiatry & Wellness LLC's NPI number?

The NPI number for Resonancebridge Psychiatry & Wellness LLC is 1639034770. It was assigned to this organization in the NPPES registry on December 20, 2025.

Where is Resonancebridge Psychiatry & Wellness LLC located?

Resonancebridge Psychiatry & Wellness LLC is located at 12682 88th Ave N, Maple Grove, MN 55369. The listed phone number is (612) 482-2034.

What is Resonancebridge Psychiatry & Wellness LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Resonancebridge Psychiatry & Wellness LLC was last updated on September 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days 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.