| Meditelecare Of Minnesota Pllc | |
|
1010 Dale St N Saint Paul MN 55117-5603 | |
| (860) 788-6404 | |
| (860) 829-0495 |
| Full Name | Meditelecare Of Minnesota Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1010 Dale St N, Saint Paul, Minnesota |
| Authorized Official Name and Position | Teresa Trojanowski (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Contact | 8607886404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meditelecare Of Minnesota Pllc Po Box 1595 Middletown CT 06457-8095 Ph: (860) 788-6404 | Meditelecare Of Minnesota Pllc 1010 Dale St N Saint Paul MN 55117-5603 Ph: (860) 788-6404 |
| NPI Number | 1427558972 |
|---|---|
| Provider Enumeration Date | 02/20/2018 |
| Last Update Date | 01/07/2020 |
| Certification Date | 01/07/2020 |
| Medicare PECOS PAC ID | 5092078402 |
|---|---|
| Medicare Enrollment ID | O20180418000927 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427558972 | NPI | - | NPPES |
| Provider Name | Christopher Lee Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871985564 PECOS PAC ID: 5698096360 Enrollment ID: I20170508002381 |
| Provider Name | Mardiya K Jaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215436076 PECOS PAC ID: 1254695042 Enrollment ID: I20180502001710 |
| Provider Name | Cheryl A France |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134144215 PECOS PAC ID: 1557550175 Enrollment ID: I20190416001673 |
| Provider Name | Melissa Jean Chalmers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245582055 PECOS PAC ID: 3173866688 Enrollment ID: I20190528000081 |
| Provider Name | Tiney Elizabeth Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154331346 PECOS PAC ID: 3870680457 Enrollment ID: I20200709001476 |
| Provider Name | Dana Eason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710190715 PECOS PAC ID: 7315267580 Enrollment ID: I20210428002242 |
| Provider Name | Amy Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851912257 PECOS PAC ID: 0840614657 Enrollment ID: I20221115000220 |
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