Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Alemu Kassa Reta

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1790490241

Alemu Kassa Reta is a Nurse Practitioner in Center City, Minnesota. Qualified in 2022, 4 years ago. Practices as a sole proprietor. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2023

Practice location Address checks out

15251 Pleasant Valley Rd
Center City, MN 55012-9640
Phone: (651) 213-4984
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 9751 (MN)

Record details

NPI number1790490241
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 19, 2023
Last updated in NPPESJanuary 19, 2023
Certification dateJanuary 19, 2023
Mailing address3318 138th Ave Nw, Andover, MN 55304-7508

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare