Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michael Glenn Petty, RN, ACNS-BC, CCNS

Individual provider Critical Care Medicine Registered Nurse · NPI 1255951216

Michael Glenn Petty, RN, ACNS-BC, CCNS is a Critical Care Medicine Registered Nurse in Minneapolis, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2020
Specialties on file
3
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone: (612) 273-5607
Fax: (612) 273-9966
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Clinical Nurse Specialist (primary) Taxonomy 364SA2200X · Licence 71 (MN)
Critical Care Medicine Registered Nurse Taxonomy 163WC0200X · Licence 095570 (MN)
Critical Care Medicine Clinical Nurse Specialist Taxonomy 364SC0200X · Licence 71 (MN)

Record details

NPI number1255951216
Entity typeIndividual (Type 1)
GenderMale
Credentials RN , ACNS-BC , CCNS
Sole proprietorYes
NPI enumeratedApril 20, 2020
Last updated in NPPESApril 20, 2020
Certification dateApril 20, 2020

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