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

Beth Dougherty, AGNP-C

Individual provider Nurse Practitioner · NPI 1558757641

Beth Dougherty, AGNP-C is a Nurse Practitioner in St Louis Park, Minnesota. Qualified in 2014, 12 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
12
Licensed in
MN
In the registry since
2015
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Practice location Address checks out

3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone: (952) 993-3230
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7300 France Ave S Ste 400, Edina, MN 55435-4544 — (952) 374-5995

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence CNP3840 (MN)

Record details

NPI number1558757641
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP-C
Sole proprietorNo
NPI enumeratedApril 15, 2015
Last updated in NPPESJune 7, 2021
Certification dateJune 7, 2021
Mailing address8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in St Louis Park