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

Connie Jaenicke, NP

Individual provider Family Nurse Practitioner · NPI 1508875063

Connie Jaenicke, NP is a Nurse Practitioner in Burnsville, Minnesota. Qualified in 2005, 21 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
21
Licensed in
MN
In the registry since
2006
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone: (952) 993-8700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 Veterans Dr, Minneapolis, MN 55417-2309 — (612) 467-4914

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence CNP1484 (MN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 142515-0 (MN)

Record details

NPI number1508875063
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedAugust 5, 2006
Last updated in NPPESAugust 31, 2023
Certification dateAugust 31, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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