Integrated Wound Care Minnesota Pllc | |
433 County Road 30 Se Delano MN 55328-9000 | |
(718) 705-6010 | |
Not Available |
Full Name | Integrated Wound Care Minnesota Pllc |
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Speciality | General Practice |
Location | 433 County Road 30 Se, Delano, Minnesota |
Authorized Official Name and Position | Diane Lusas (PRESIDENT) |
Authorized Official Contact | 7187056010 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Integrated Wound Care Minnesota Pllc 492c Cedar Ln Ste 514 Teaneck NJ 07666-1713 Ph: (718) 705-6010 | Integrated Wound Care Minnesota Pllc 433 County Road 30 Se Delano MN 55328-9000 Ph: (718) 705-6010 |
NPI Number | 1205390457 |
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Provider Enumeration Date | 01/22/2019 |
Last Update Date | 06/02/2020 |
Medicare PECOS PAC ID | 2769722511 |
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Medicare Enrollment ID | O20190314001268 |
Identifier | Type | State | Issuer |
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1205390457 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Tammy L Davis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528134129 PECOS PAC ID: 6901824333 Enrollment ID: I20051104000042 |
Provider Name | M Elizabeth Mcnutt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306032065 PECOS PAC ID: 9537247549 Enrollment ID: I20080416000277 |
Provider Name | Michaela A Mclain |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003046996 PECOS PAC ID: 7719025501 Enrollment ID: I20091116000597 |
Provider Name | Kara L Fausch |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1417124553 PECOS PAC ID: 6103965553 Enrollment ID: I20091125000212 |
Provider Name | Sarah E Blanshan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518273622 PECOS PAC ID: 2466648779 Enrollment ID: I20101129001076 |
Provider Name | Stephanie J Garofalo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811324437 PECOS PAC ID: 9234365370 Enrollment ID: I20131120001555 |
Provider Name | Mary E Jaeger |
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Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1891129425 PECOS PAC ID: 4385867142 Enrollment ID: I20140523000225 |
Provider Name | Inemienyu N Evbakhare |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225307135 PECOS PAC ID: 6901063312 Enrollment ID: I20150515000443 |
Provider Name | Kristin M Stevens |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962882696 PECOS PAC ID: 0648584243 Enrollment ID: I20150727001483 |
Provider Name | Kimberly K Grob |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851747091 PECOS PAC ID: 9638469927 Enrollment ID: I20160526002509 |
Provider Name | Alicia H Keeler |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598039463 PECOS PAC ID: 4284895624 Enrollment ID: I20170117000894 |
Provider Name | Diane Lusas |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1730475658 PECOS PAC ID: 9032430640 Enrollment ID: I20190314001341 |
Provider Name | Hudson M Omweri |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285190132 PECOS PAC ID: 5395088702 Enrollment ID: I20190528000324 |
Provider Name | Jillian S Simon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730713157 PECOS PAC ID: 9335570340 Enrollment ID: I20200507000517 |
Provider Name | Virginia Otey Villarreal |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518583590 PECOS PAC ID: 0042639379 Enrollment ID: I20201006000705 |
Provider Name | Angela Ngozi Ikeri |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982945937 PECOS PAC ID: 5092127712 Enrollment ID: I20201221002375 |
Provider Name | Nargiza S. Akyol |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396324331 PECOS PAC ID: 9638560030 Enrollment ID: I20211220000104 |
Provider Name | Sarah I Hare |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033886734 PECOS PAC ID: 0648510966 Enrollment ID: I20211222000607 |
Provider Name | Chantelle Alice Lou Fieber |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629663935 PECOS PAC ID: 5991113912 Enrollment ID: I20220207000176 |
Provider Name | Sara H Perry |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699443424 PECOS PAC ID: 3971996844 Enrollment ID: I20220217001511 |
Provider Name | Christina Richardson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336803691 PECOS PAC ID: 0345634523 Enrollment ID: I20220304000411 |
Provider Name | Laura Lee Zweber |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841345139 PECOS PAC ID: 9638564420 Enrollment ID: I20220314000973 |
Provider Name | Ann Marie Sinda Equio |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497487813 PECOS PAC ID: 5395128359 Enrollment ID: I20220824001193 |
Provider Name | Sarah Cushman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275924821 PECOS PAC ID: 1658673181 Enrollment ID: I20220824003557 |
Provider Name | Abolfazl Kowsari |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073172003 PECOS PAC ID: 9931584562 Enrollment ID: I20220919002244 |
Provider Name | Brianna Marsh |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174287478 PECOS PAC ID: 5799178547 Enrollment ID: I20230110001344 |
Provider Name | Sarah Marie Wilm Hunter |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972215598 PECOS PAC ID: 8628442316 Enrollment ID: I20230320002840 |
Provider Name | Michelle Trevino |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447960604 PECOS PAC ID: 9638535784 Enrollment ID: I20240123002685 |
Provider Name | Jessica Freudenthal |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114485364 PECOS PAC ID: 1153662853 Enrollment ID: I20240612000732 |
Big Woods Health Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 620 Babcock Blvd E, Delano, MN 55328 Phone: 763-229-3365 | |
Ridgeview Delano Clinic/western Orthopaedics & Sports Medicine Consult Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 916 Saint Peter St, Delano, MN 55328 Phone: 763-972-9172 Fax: 763-972-9531 |