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

Kimberly Spivack, MSN

Individual provider Primary Care Nurse Practitioner · NPI 1376357814

Kimberly Spivack, MSN is a Nurse Practitioner in Glenwood, Minnesota. Qualified in 2024, 2 years ago. Practices with Glacial Ridge Hospital District, a 69-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
2
Licensed in
MN
In the registry since
2025
Specialties on file
2
What do these letters mean?
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.

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Practice location Address checks out

10 4th Ave SE
Glenwood, MN 56334-1820
Phone: (320) 634-4521
Show map & directions

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

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 12514 (MN)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence 12514 (MN)

Record details

NPI number1376357814
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSN
Sole proprietorNo
NPI enumeratedFebruary 5, 2025
Last updated in NPPESFebruary 5, 2025
Certification dateJanuary 21, 2025
Mailing address1240 W Main St, Paynesville, MN 56362-1040

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Glacial Ridge Hospital District — 69 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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