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

Kenyata Tyeshia Carroll, FNP, CNP

Individual provider Family Nurse Practitioner · NPI 1588542245

Kenyata Tyeshia Carroll, FNP, CNP is a Nurse Practitioner in Minneapolis, Minnesota. Graduated from University of North Dakota School of Medicine in 2023, 3 years ago. Practices with Southside Community Health Services Inc, a 17-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
3
Trained at
University of North Dakota School of Medicine
Licensed in
MN
In the registry since
2025
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

324 E 35th St
Minneapolis, MN 55408-4580
Phone: (612) 827-7181
Fax: (612) 767-4545
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 12819 (MN)

Record details

NPI number1588542245
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP , CNP
Sole proprietorNo
NPI enumeratedAugust 21, 2025
Last updated in NPPESAugust 21, 2025
Certification dateAugust 21, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE
Graduated 2023 (3 years in practice)
Group practice Southside Community Health Services Inc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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