MEDICARE: ROSEMARY BAKHITA JAMES PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	12245	MN
2	2084P0800X	Psychiatry Physician	12245	MN

General Provider Information

NPI Number	:	1437970027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARY BAKHITA JAMES PMHNP

Provider Business Mailing Address
First Line	:	13301 MAPLE KNOLL WAY APT 302
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-7002
Country	:	US
Telephone Number	:	763-400-6282
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 E 28TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-3723
Country	:	US
Telephone Number	:	612-863-4048
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2024
Last Update Date	:	12/03/2025

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