| Sanford Health Southeast Campus | |
|
1720 Highway 59 S Thief River Falls MN 56701-4331 | |
| (218) 681-4747 | |
| (218) 683-2595 |
| Full Name | Sanford Health Southeast Campus |
|---|---|
| Speciality | Clinic/Center |
| Location | 1720 Highway 59 S, Thief River Falls, Minnesota |
| Authorized Official Name and Position | Tony Lee Morrison (VICE PRESIDENT, REVENUE CYCLE) |
| Authorized Official Contact | 6053288380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanford Health Southeast Campus Po Box 5074 Sioux Falls SD 57117-5074 Ph: (605) 328-6585 | Sanford Health Southeast Campus 1720 Highway 59 S Thief River Falls MN 56701-4331 Ph: (218) 681-4747 |
| NPI Number | 1386047355 |
|---|---|
| Provider Enumeration Date | 10/03/2014 |
| Last Update Date | 11/27/2023 |
| Certification Date | 06/30/2020 |
| Medicare PECOS PAC ID | 8022206663 |
|---|---|
| Medicare Enrollment ID | O20180205002429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386047355 | NPI | - | NPPES |
| Provider Name | David M Schall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932170057 PECOS PAC ID: 7416869805 Enrollment ID: I20031104000339 |
| Provider Name | Kevin R Wentworth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639270069 PECOS PAC ID: 5193629988 Enrollment ID: I20031124000098 |
| Provider Name | Michael J Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215967898 PECOS PAC ID: 2961307194 Enrollment ID: I20031202000073 |
| Provider Name | Daniel W Louvar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1912984923 PECOS PAC ID: 0345143293 Enrollment ID: I20040129000148 |
| Provider Name | Kathi Jo Kremer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295744837 PECOS PAC ID: 7113810896 Enrollment ID: I20040205000983 |
| Provider Name | Steven L Andersen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962453993 PECOS PAC ID: 8628962180 Enrollment ID: I20040214000128 |
| Provider Name | Kevin D Ballard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700825981 PECOS PAC ID: 2860388931 Enrollment ID: I20040225000718 |
| Provider Name | James B Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336191030 PECOS PAC ID: 3678556594 Enrollment ID: I20040611000142 |
| Provider Name | Panjini M Sivanna |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1013948116 PECOS PAC ID: 7315843596 Enrollment ID: I20040708000425 |
| Provider Name | Michelle Barbara Rinke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730198383 PECOS PAC ID: 9830159169 Enrollment ID: I20041012000920 |
| Provider Name | Jawad H Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083657035 PECOS PAC ID: 4981666195 Enrollment ID: I20041101000015 |
| Provider Name | Mario J Potvin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003869637 PECOS PAC ID: 4688587355 Enrollment ID: I20041124000392 |
| Provider Name | Troy D Erickson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861568289 PECOS PAC ID: 2769430131 Enrollment ID: I20050112000450 |
| Provider Name | Eileen M Channel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497831580 PECOS PAC ID: 0648229286 Enrollment ID: I20050120000680 |
| Provider Name | Jennifer J Arnhold |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043283203 PECOS PAC ID: 7810940665 Enrollment ID: I20050222000407 |
| Provider Name | Curtis C Krueger |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952341026 PECOS PAC ID: 3274501192 Enrollment ID: I20050321000137 |
| Provider Name | Nicole A Lingen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1457393704 PECOS PAC ID: 8628019197 Enrollment ID: I20050513000761 |
| Provider Name | Sharon R Cannon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578580577 PECOS PAC ID: 6507807609 Enrollment ID: I20050519000093 |
| Provider Name | Teague A Dombeck |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407815558 PECOS PAC ID: 1153363130 Enrollment ID: I20050601000029 |
| Provider Name | Scott W Petrescue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043302474 PECOS PAC ID: 5890608038 Enrollment ID: I20060428000500 |
| Provider Name | Malcolm B Parker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700854544 PECOS PAC ID: 9436164258 Enrollment ID: I20060725000286 |
| Provider Name | Eric C Pearson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003835984 PECOS PAC ID: 7719914217 Enrollment ID: I20060823000369 |
| Provider Name | Andrew L Makowski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770514861 PECOS PAC ID: 4385648021 Enrollment ID: I20060911000634 |
| Provider Name | Jason Bentley Nupdal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881625150 PECOS PAC ID: 4284639402 Enrollment ID: I20060921000589 |
| Provider Name | Angela Joy Wood |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1235237439 PECOS PAC ID: 5496751695 Enrollment ID: I20061011000419 |
| Provider Name | David A Galloway |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1700993813 PECOS PAC ID: 3577561349 Enrollment ID: I20061110000311 |
| Provider Name | Chad Eugene Boen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215034095 PECOS PAC ID: 9133117443 Enrollment ID: I20070205000622 |
| Provider Name | Mary C Macleod |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972695302 PECOS PAC ID: 9739147844 Enrollment ID: I20070226000020 |
| Provider Name | Kory Albert |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326148859 PECOS PAC ID: 2264339803 Enrollment ID: I20070330000125 |
| Provider Name | Natasha Siefker Cook |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528103421 PECOS PAC ID: 4385749936 Enrollment ID: I20070410000625 |
| Provider Name | Timothy M Nyarandi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124222351 PECOS PAC ID: 5092808360 Enrollment ID: I20070912000323 |
| Provider Name | Desiree Marie Bertilrud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164603460 PECOS PAC ID: 5092896019 Enrollment ID: I20080116000342 |
| Provider Name | Bruce E Piatt |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972532240 PECOS PAC ID: 7618066283 Enrollment ID: I20080119000007 |
| Provider Name | Heeraimangalore S Manjunath |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1366472441 PECOS PAC ID: 5193782951 Enrollment ID: I20080121000080 |
| Provider Name | Kevin W Rook |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790731735 PECOS PAC ID: 2668554981 Enrollment ID: I20080125000285 |
| Provider Name | Sanjay G Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629004569 PECOS PAC ID: 3375625544 Enrollment ID: I20080126000069 |
| Provider Name | Mark Edward Yuska |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114953031 PECOS PAC ID: 1557443728 Enrollment ID: I20080126000074 |
| Provider Name | Khaled S Zreik |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437320710 PECOS PAC ID: 6406929587 Enrollment ID: I20080723000186 |
| Provider Name | Laurie Straw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467473686 PECOS PAC ID: 2466353982 Enrollment ID: I20080917000859 |
| Provider Name | Joseph V Lazzara |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609844166 PECOS PAC ID: 9032287149 Enrollment ID: I20081002000345 |
| Provider Name | James E Halvorson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972521524 PECOS PAC ID: 6103994926 Enrollment ID: I20081007000495 |
| Provider Name | Patrick E Emery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144247008 PECOS PAC ID: 7618037060 Enrollment ID: I20081115000141 |
| Provider Name | Erika K Beckett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861649071 PECOS PAC ID: 9638230279 Enrollment ID: I20081202000100 |
| Provider Name | Christian Cavanaugh Conner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003068743 PECOS PAC ID: 8325100837 Enrollment ID: I20081217000470 |
| Provider Name | Roderick Ralph Byron |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003849092 PECOS PAC ID: 7416013651 Enrollment ID: I20090312000676 |
| Provider Name | Charles J Breen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114944113 PECOS PAC ID: 2668402660 Enrollment ID: I20090313000211 |
| Provider Name | Garrel C Kinzler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740432558 PECOS PAC ID: 1254496037 Enrollment ID: I20090324000575 |
| Provider Name | Amit W Panwalkar |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1043426034 PECOS PAC ID: 5698840247 Enrollment ID: I20090507000646 |
| Provider Name | Timothy J Luithle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578581146 PECOS PAC ID: 2769533355 Enrollment ID: I20090622000207 |
| Provider Name | Stephen Patrick Garrity |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033137682 PECOS PAC ID: 6901957570 Enrollment ID: I20090623000255 |
| Provider Name | Jason M Asheim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780693424 PECOS PAC ID: 8628077872 Enrollment ID: I20090710000242 |
| Provider Name | Jonathan Ross Fish |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629117890 PECOS PAC ID: 6103979836 Enrollment ID: I20090728000902 |
| Provider Name | Kevin A Dahl |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356551089 PECOS PAC ID: 7517010580 Enrollment ID: I20090810000165 |
| Provider Name | Allison J Clapp |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366694614 PECOS PAC ID: 2264587369 Enrollment ID: I20090825000519 |
| Provider Name | Matthew John Dammeyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083838403 PECOS PAC ID: 8921177114 Enrollment ID: I20090826000426 |
| Provider Name | Chetan P Maingi |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1952408809 PECOS PAC ID: 1254338551 Enrollment ID: I20091223000443 |
| Provider Name | Glenn A Gaunt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932183050 PECOS PAC ID: 3779487913 Enrollment ID: I20100218000754 |
| Provider Name | Edwin D Turner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982660676 PECOS PAC ID: 6204965031 Enrollment ID: I20100603000521 |
| Provider Name | Andrew M Bakken |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1376648113 PECOS PAC ID: 2163556267 Enrollment ID: I20100811000434 |
| Provider Name | Donald J Stallman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386665503 PECOS PAC ID: 4880889880 Enrollment ID: I20101116001132 |
| Provider Name | Elizabeth L Jahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043524465 PECOS PAC ID: 5496941619 Enrollment ID: I20101130000191 |
| Provider Name | Doron M Spierer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356654388 PECOS PAC ID: 1456547561 Enrollment ID: I20101130001425 |
| Provider Name | Alison L Toren |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871803528 PECOS PAC ID: 5294921318 Enrollment ID: I20101201000069 |
| Provider Name | Trenton A Barstad |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942370671 PECOS PAC ID: 5294917878 Enrollment ID: I20110303000841 |
| Provider Name | Thomas Michael Peterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639131014 PECOS PAC ID: 7911809843 Enrollment ID: I20110324000372 |
| Provider Name | Brent R Williams |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1710125893 PECOS PAC ID: 8921151093 Enrollment ID: I20110425000664 |
| Provider Name | Yongsheng Ren |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1770510828 PECOS PAC ID: 1850395617 Enrollment ID: I20110622000501 |
| Provider Name | Christopher G Kallenbach |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649460551 PECOS PAC ID: 3870645492 Enrollment ID: I20110629000721 |
| Provider Name | Susan K Hofland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265453492 PECOS PAC ID: 0042406902 Enrollment ID: I20110719000289 |
| Provider Name | Joeanna L Aasen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154617256 PECOS PAC ID: 7810166055 Enrollment ID: I20110804000622 |
| Provider Name | Erica Leigh Martin-macintosh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124344858 PECOS PAC ID: 0648441741 Enrollment ID: I20110921000700 |
| Provider Name | Mark Tsibulsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518915511 PECOS PAC ID: 7315040581 Enrollment ID: I20111010000480 |
| Provider Name | Christopher L Kelly |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1801827266 PECOS PAC ID: 3173676996 Enrollment ID: I20111221000751 |
| Provider Name | John W Hoscheid |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831387976 PECOS PAC ID: 8022104058 Enrollment ID: I20120113000143 |
| Provider Name | Mark M Gitau |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1225073661 PECOS PAC ID: 0547391757 Enrollment ID: I20120320000056 |
| Provider Name | Evans O Magambo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881824407 PECOS PAC ID: 3476709825 Enrollment ID: I20120817000319 |
| Provider Name | Patrick C Jahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437406907 PECOS PAC ID: 1850543927 Enrollment ID: I20121218000587 |
| Provider Name | Jon D Dangerfield |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245258896 PECOS PAC ID: 2860686904 Enrollment ID: I20130417000134 |
| Provider Name | Chris L Cleveland |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1982693875 PECOS PAC ID: 6901052471 Enrollment ID: I20131203000026 |
| Provider Name | Carissa R Arens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962830026 PECOS PAC ID: 9537396072 Enrollment ID: I20131209000859 |
| Provider Name | Myles W Brandt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275955767 PECOS PAC ID: 1052542750 Enrollment ID: I20140321001519 |
| Provider Name | Ann R Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902122104 PECOS PAC ID: 0941433106 Enrollment ID: I20140424000566 |
| Provider Name | Grant W Botker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295026532 PECOS PAC ID: 5294980009 Enrollment ID: I20140807002191 |
| Provider Name | Alyssa K Thooft |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1366859456 PECOS PAC ID: 2860611472 Enrollment ID: I20140915000275 |
| Provider Name | Daniel L Icenogle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598714016 PECOS PAC ID: 2264409648 Enrollment ID: I20140926000380 |
| Provider Name | Karen Marie Schleehauf |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346244332 PECOS PAC ID: 8426039389 Enrollment ID: I20141009000402 |
| Provider Name | Travis J Mattern |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376561977 PECOS PAC ID: 4486541869 Enrollment ID: I20141028002160 |
| Provider Name | Eram Shahira |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1578762548 PECOS PAC ID: 1052403672 Enrollment ID: I20150127001824 |
| Provider Name | Tong Yang |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1427169788 PECOS PAC ID: 7810139987 Enrollment ID: I20150401000477 |
| Provider Name | Richard Walter Pretorius |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013900505 PECOS PAC ID: 4688561517 Enrollment ID: I20150515000330 |
| Provider Name | Natalee H Schultz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023400355 PECOS PAC ID: 2466772314 Enrollment ID: I20150518001343 |
| Provider Name | John D Shirkey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346631371 PECOS PAC ID: 7113248337 Enrollment ID: I20150530000206 |
| Provider Name | Jacqueline Materi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881088383 PECOS PAC ID: 8820319833 Enrollment ID: I20150602003080 |
| Provider Name | David B Nuelle |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376737536 PECOS PAC ID: 9436230364 Enrollment ID: I20150804006054 |
| Provider Name | Brian J Hamm |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952542995 PECOS PAC ID: 4981919016 Enrollment ID: I20150826002265 |
| Provider Name | Katherine Joseph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124381470 PECOS PAC ID: 0345564878 Enrollment ID: I20150918002786 |
| Provider Name | Jefferson Reynolds |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417386483 PECOS PAC ID: 5294966875 Enrollment ID: I20151016002144 |
| Provider Name | Mike D Traynor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841212412 PECOS PAC ID: 5991832669 Enrollment ID: I20160128000186 |
| Provider Name | Carlos D Miranda |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235446865 PECOS PAC ID: 4981913068 Enrollment ID: I20160803002553 |
| Provider Name | James A Macdonald |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558510792 PECOS PAC ID: 4981857349 Enrollment ID: I20160829001927 |
| Provider Name | Rebecca A Stroklund |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700046927 PECOS PAC ID: 0941343446 Enrollment ID: I20161221001458 |
| Provider Name | Gregory M Olszewski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952741050 PECOS PAC ID: 6608096748 Enrollment ID: I20170213002686 |
| Provider Name | Brandon P Taylor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598902181 PECOS PAC ID: 2567510472 Enrollment ID: I20170315001344 |
| Provider Name | Mia M Kozojed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124281043 PECOS PAC ID: 1759456627 Enrollment ID: I20170511000197 |
| Provider Name | Stacy A Cederstrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174079917 PECOS PAC ID: 2365727336 Enrollment ID: I20170531001596 |
| Provider Name | Mark A Dupont |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1003932518 PECOS PAC ID: 5991072563 Enrollment ID: I20170602000286 |
| Provider Name | Dawn Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124557103 PECOS PAC ID: 5294006581 Enrollment ID: I20170804000796 |
| Provider Name | Abbey Lee Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891215836 PECOS PAC ID: 7719250497 Enrollment ID: I20170830003760 |
| Provider Name | Tammy A Lafreniere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619404241 PECOS PAC ID: 1850664574 Enrollment ID: I20170831001365 |
| Provider Name | Deanna M Balvitsch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124045117 PECOS PAC ID: 9133312275 Enrollment ID: I20171107003149 |
| Provider Name | Timothy P Uglem |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1396766630 PECOS PAC ID: 4183740913 Enrollment ID: I20171206001894 |
| Provider Name | Ellen D Vogels |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417255191 PECOS PAC ID: 1850696105 Enrollment ID: I20180108002546 |
| Provider Name | Thomas A Haldis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588681449 PECOS PAC ID: 6305748260 Enrollment ID: I20180112000669 |
| Provider Name | John Christopher Asleson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114190493 PECOS PAC ID: 1254404536 Enrollment ID: I20180418001928 |
| Provider Name | Kimber L Osowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982660908 PECOS PAC ID: 5294922563 Enrollment ID: I20180607003143 |
| Provider Name | Sharri M Lacher |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1316315385 PECOS PAC ID: 5890097307 Enrollment ID: I20180611002336 |
| Provider Name | Kari A Reveland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285029843 PECOS PAC ID: 0648579789 Enrollment ID: I20180702000006 |
| Provider Name | Amy M Phillips |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952796948 PECOS PAC ID: 5193027464 Enrollment ID: I20180702002704 |
| Provider Name | Christina Rose Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215431853 PECOS PAC ID: 8628326618 Enrollment ID: I20180808000643 |
| Provider Name | Kerry A Stevens |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891934311 PECOS PAC ID: 1153472048 Enrollment ID: I20180816000015 |
| Provider Name | Dawn Marie Ellis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790275196 PECOS PAC ID: 3870842800 Enrollment ID: I20180823002061 |
| Provider Name | Roy T Klossner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649562356 PECOS PAC ID: 7517264146 Enrollment ID: I20180829000237 |
| Provider Name | Mark J Zarzycki |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215972930 PECOS PAC ID: 9830156991 Enrollment ID: I20180830003528 |
| Provider Name | David S Chou |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710926878 PECOS PAC ID: 3072417500 Enrollment ID: I20180917000105 |
| Provider Name | Tanner C Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689108573 PECOS PAC ID: 0345511820 Enrollment ID: I20181003002180 |
| Provider Name | Andrew Rook |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356859979 PECOS PAC ID: 1850644683 Enrollment ID: I20181025000151 |
| Provider Name | Sugong Chen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487972972 PECOS PAC ID: 9436388220 Enrollment ID: I20181102000750 |
| Provider Name | Ashley L Holtan |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1033603683 PECOS PAC ID: 3971856154 Enrollment ID: I20181106000609 |
| Provider Name | Arshad B Khan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184900466 PECOS PAC ID: 4183978463 Enrollment ID: I20181127000661 |
| Provider Name | Raghavesh Pullalarevu |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1689985079 PECOS PAC ID: 0446408868 Enrollment ID: I20181206000275 |
| Provider Name | Molly A Berg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285081323 PECOS PAC ID: 2567754393 Enrollment ID: I20190130000425 |
| Provider Name | Radha Krishna Rao Vegunta |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1750669214 PECOS PAC ID: 0244534949 Enrollment ID: I20190417002897 |
| Provider Name | Katherine L Byron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255469284 PECOS PAC ID: 4486758075 Enrollment ID: I20190514001495 |
| Provider Name | Benjamin Andrew Kitt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750776530 PECOS PAC ID: 2860706033 Enrollment ID: I20190709000318 |
| Provider Name | Amanda Jurvis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083063069 PECOS PAC ID: 3375834849 Enrollment ID: I20190719002734 |
| Provider Name | Leslie Adrian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437509874 PECOS PAC ID: 3476840133 Enrollment ID: I20190801001651 |
| Provider Name | Michael Dean Branby |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811237753 PECOS PAC ID: 5698911907 Enrollment ID: I20190815001440 |
| Provider Name | Dennis A Silver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780726273 PECOS PAC ID: 9234295528 Enrollment ID: I20190911000010 |
| Provider Name | Samantha J Hulst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487212205 PECOS PAC ID: 9638409030 Enrollment ID: I20190927001679 |
| Provider Name | Parth A Vyas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083981567 PECOS PAC ID: 4082845029 Enrollment ID: I20191001001079 |
| Provider Name | Rebecca A Schulz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881247575 PECOS PAC ID: 0547590721 Enrollment ID: I20191002000073 |
| Provider Name | Helia Farrokhzad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508215344 PECOS PAC ID: 1850623661 Enrollment ID: I20191029000331 |
| Provider Name | Rozlynn O Johnsrud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548800535 PECOS PAC ID: 0042647919 Enrollment ID: I20200305002199 |
| Provider Name | Daaron A Mcfield |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306045984 PECOS PAC ID: 5092018705 Enrollment ID: I20200504002776 |
| Provider Name | Sarah Markuson Raleigh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255863221 PECOS PAC ID: 2860813805 Enrollment ID: I20200601000099 |
| Provider Name | Jennifer Rose Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770103129 PECOS PAC ID: 9638591019 Enrollment ID: I20200615000029 |
| Provider Name | Davis John Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063035608 PECOS PAC ID: 5890118582 Enrollment ID: I20200714002267 |
| Provider Name | Allison J Henrickson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1376199810 PECOS PAC ID: 6406271295 Enrollment ID: I20200811001448 |
| Provider Name | David Jt Collins |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104347426 PECOS PAC ID: 8123398765 Enrollment ID: I20200820001971 |
| Provider Name | David D Gibbons |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356729990 PECOS PAC ID: 1355656653 Enrollment ID: I20200903002469 |
| Provider Name | Sarah E Fischer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124478565 PECOS PAC ID: 4082900600 Enrollment ID: I20200908003266 |
| Provider Name | Ryan Douglas Reynolds |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568662252 PECOS PAC ID: 2668621186 Enrollment ID: I20200910000505 |
| Provider Name | Benjamin L Dahl |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558565762 PECOS PAC ID: 1850583519 Enrollment ID: I20200928000336 |
| Provider Name | Brady S Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881212819 PECOS PAC ID: 5294154076 Enrollment ID: I20200928002608 |
| Provider Name | Sara Beth Beger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659989200 PECOS PAC ID: 7618396433 Enrollment ID: I20200929000737 |
| Provider Name | Xiaoying Deng |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1649463647 PECOS PAC ID: 0941473953 Enrollment ID: I20201001000495 |
| Provider Name | Derek Anthony Mclister |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114453552 PECOS PAC ID: 9032537873 Enrollment ID: I20201002001836 |
| Provider Name | Thomas Philip Kennedy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881985182 PECOS PAC ID: 0345474185 Enrollment ID: I20201002002857 |
| Provider Name | Daniel Wallace Dahl |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285884767 PECOS PAC ID: 8921271164 Enrollment ID: I20201009000200 |
| Provider Name | Seth A Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528210879 PECOS PAC ID: 9133367998 Enrollment ID: I20201019000420 |
| Provider Name | Carol L Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578956702 PECOS PAC ID: 9830509827 Enrollment ID: I20201103000411 |
| Provider Name | Matthew P Lazio |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790978260 PECOS PAC ID: 6608913942 Enrollment ID: I20201106000040 |
| Provider Name | Beth Peterick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720685167 PECOS PAC ID: 4385056340 Enrollment ID: I20201215003307 |
| Provider Name | Andrew J Humes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699260117 PECOS PAC ID: 4486067725 Enrollment ID: I20210106001481 |
| Provider Name | Sherrie Ann Kahn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710585286 PECOS PAC ID: 0648684936 Enrollment ID: I20210127003178 |
| Provider Name | Mahmoud Mahmoud |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1457715161 PECOS PAC ID: 4284923624 Enrollment ID: I20210211001793 |
| Provider Name | Heather Lynn Waldal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225629777 PECOS PAC ID: 3779990072 Enrollment ID: I20210405000662 |
| Provider Name | Alfredo Fernando Valdez Valencia |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841785334 PECOS PAC ID: 7517364672 Enrollment ID: I20210916002413 |
| Provider Name | Matthew S Viscito |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497969570 PECOS PAC ID: 9537227079 Enrollment ID: I20220103000807 |
| Provider Name | Subba Alapati |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487642039 PECOS PAC ID: 7012974686 Enrollment ID: I20220111001983 |
| Provider Name | Jared Alexander Marquardt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235541756 PECOS PAC ID: 2668794702 Enrollment ID: I20220420001563 |
| Provider Name | John J Evans |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1093079709 PECOS PAC ID: 4880956283 Enrollment ID: I20220427001434 |
| Provider Name | Sarah Omar Modawi Hamad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992298103 PECOS PAC ID: 4082091160 Enrollment ID: I20220510002572 |
| Provider Name | Michelle Rae Neuschwander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023685138 PECOS PAC ID: 5193104354 Enrollment ID: I20220617000778 |
| Provider Name | January Aisha Hill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174757462 PECOS PAC ID: 0345487690 Enrollment ID: I20220830004200 |
| Provider Name | William Cody Sessions |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1710412945 PECOS PAC ID: 0749559607 Enrollment ID: I20221027000643 |
| Provider Name | Jennifer Ellen Vermillion |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1841938065 PECOS PAC ID: 4981071818 Enrollment ID: I20221107002302 |
| Provider Name | Morgan R Rinke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154807741 PECOS PAC ID: 4789935545 Enrollment ID: I20221205001652 |
| Provider Name | Patricia Rae Kuznia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811616345 PECOS PAC ID: 2264802982 Enrollment ID: I20221221001046 |
| Provider Name | Taylor Marie Vasek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538806146 PECOS PAC ID: 5698145704 Enrollment ID: I20230106000982 |
| Provider Name | Rachel Ellen Kreitzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992419220 PECOS PAC ID: 0749653673 Enrollment ID: I20230223002605 |
| Provider Name | Bailey Nichole Ranum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174248264 PECOS PAC ID: 5991178568 Enrollment ID: I20230301001270 |
| Provider Name | Jessica Anne Silveri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194175422 PECOS PAC ID: 9032405972 Enrollment ID: I20230307001399 |
| Provider Name | Utkucan Acar |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1609397421 PECOS PAC ID: 0345676755 Enrollment ID: I20230307001422 |
| Provider Name | Heather Erin Kranitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902320682 PECOS PAC ID: 1052738804 Enrollment ID: I20230424000745 |
| Provider Name | Kyle Laurence Slaathaug |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144947045 PECOS PAC ID: 7618332503 Enrollment ID: I20230427002970 |
| Provider Name | Jennifer A Harrison |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033200837 PECOS PAC ID: 1658361852 Enrollment ID: I20230517001260 |
| Provider Name | Ronald M Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962485714 PECOS PAC ID: 6800827270 Enrollment ID: I20230628004038 |
| Provider Name | Mary M Schultz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265414676 PECOS PAC ID: 6305977430 Enrollment ID: I20230713001129 |
| Provider Name | Hassan B Attique |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1033562525 PECOS PAC ID: 5991091258 Enrollment ID: I20230714000293 |
| Provider Name | Laura Ann Slaathaug Hawley |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1881391894 PECOS PAC ID: 8224490149 Enrollment ID: I20230809002663 |
| Provider Name | Mackenzie Jane Wieser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972280550 PECOS PAC ID: 9234592627 Enrollment ID: I20230901000734 |
| Provider Name | Kathryn Ann Agamawi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1972023018 PECOS PAC ID: 6002260718 Enrollment ID: I20230929003397 |
| Provider Name | Shelby Potkin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184184277 PECOS PAC ID: 2769849900 Enrollment ID: I20231004002569 |
| Provider Name | Anna M Barth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013698364 PECOS PAC ID: 8224483284 Enrollment ID: I20231011000578 |
| Provider Name | Lisa Marie Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386321677 PECOS PAC ID: 4183079924 Enrollment ID: I20231013000563 |
| Provider Name | Mickayla Nagel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255018545 PECOS PAC ID: 9335598333 Enrollment ID: I20231215003258 |
| Provider Name | Justin J Harrington |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487189312 PECOS PAC ID: 2961773478 Enrollment ID: I20231219001679 |
| Provider Name | Kayla R Putzke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699363309 PECOS PAC ID: 7416308036 Enrollment ID: I20240109000235 |
| Provider Name | Angela Rae Hiebsch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992239628 PECOS PAC ID: 9537511548 Enrollment ID: I20240116000645 |
| Provider Name | Angelica Erickson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811466444 PECOS PAC ID: 7517302235 Enrollment ID: I20240304001469 |
| Provider Name | Trell A Kulju |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336459007 PECOS PAC ID: 1052759495 Enrollment ID: I20240404002646 |
| Provider Name | Gregory P Harders |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891746541 PECOS PAC ID: 3577575208 Enrollment ID: I20240607000542 |
Northland Christian Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 Arnold Ave N, Thief River Falls, MN 56701 Phone: 701-795-8550 | |
Pediatric Partners Neurobehavioral Health Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 419 Atlantic Ave, Thief River Falls, MN 56701 Phone: 701-232-2340 | |
Whistling Pines Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1571 Highway 59 S, Thief River Falls, MN 56701 Phone: 218-416-2682 | |
Jennifer A. Manning Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 419 3rd St E Ste B, Thief River Falls, MN 56701 Phone: 218-416-2268 | |
Storybook Wellness Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 2nd St W, Thief River Falls, MN 56701 Phone: 218-755-5050 Fax: 844-907-2090 | |
Jgsteinhauer Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 213 Labree Ave N Ste 200, Thief River Falls, MN 56701 Phone: 701-740-5138 |