| Meeker Memorial Hospital & Clinics - East/west | |
|
612 S Sibley Ave Litchfield MN 55355-3340 | |
| (320) 693-4500 | |
| Not Available |
| Full Name | Meeker Memorial Hospital & Clinics - East/west |
|---|---|
| Speciality | Clinic/Center |
| Location | 612 S Sibley Ave, Litchfield, Minnesota |
| Authorized Official Name and Position | Nicole Siegner (CFO) |
| Authorized Official Contact | 3206934512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meeker Memorial Hospital & Clinics - East/west 612 S Sibley Ave Litchfield MN 55355-3340 Ph: (320) 693-4500 | Meeker Memorial Hospital & Clinics - East/west 612 S Sibley Ave Litchfield MN 55355-3340 Ph: (320) 693-4500 |
| NPI Number | 1083221816 |
|---|---|
| Provider Enumeration Date | 09/25/2020 |
| Last Update Date | 06/11/2021 |
| Medicare PECOS PAC ID | 0840109740 |
|---|---|
| Medicare Enrollment ID | O20040216000811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083221816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Keith L Thompson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982678900 PECOS PAC ID: 2365346574 Enrollment ID: I20031120000468 |
| Provider Name | Saul S Singh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093704900 PECOS PAC ID: 2769377183 Enrollment ID: I20040216000937 |
| Provider Name | Randall J Zimmerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821005638 PECOS PAC ID: 8921995259 Enrollment ID: I20040302000604 |
| Provider Name | John J Baga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770577033 PECOS PAC ID: 0143217703 Enrollment ID: I20040427000894 |
| Provider Name | Douglas M Soderberg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215997952 PECOS PAC ID: 1557358066 Enrollment ID: I20040427001347 |
| Provider Name | Linda J Scramstad |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386654754 PECOS PAC ID: 1153310834 Enrollment ID: I20040507001238 |
| Provider Name | Francis Noel Leblanc |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881652493 PECOS PAC ID: 1254320815 Enrollment ID: I20040510000029 |
| Provider Name | Todd M Severnak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790775393 PECOS PAC ID: 2567452410 Enrollment ID: I20040513001105 |
| Provider Name | William J Lee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942270681 PECOS PAC ID: 5294718623 Enrollment ID: I20040608000894 |
| Provider Name | Mark B.o. Comnick |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1851380752 PECOS PAC ID: 9335124114 Enrollment ID: I20040624000326 |
| Provider Name | Gary Lynn Hagen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699765545 PECOS PAC ID: 1759360696 Enrollment ID: I20040715000372 |
| Provider Name | Celeste M Jibben |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891745519 PECOS PAC ID: 6103899950 Enrollment ID: I20040818001224 |
| Provider Name | Michael P Orourke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447241799 PECOS PAC ID: 1355316555 Enrollment ID: I20040901001247 |
| Provider Name | Warren D Shepard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780641688 PECOS PAC ID: 1153380241 Enrollment ID: I20041005000701 |
| Provider Name | Gordon D Walker |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1720053762 PECOS PAC ID: 2769442136 Enrollment ID: I20041012000436 |
| Provider Name | Richard M Searl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023070596 PECOS PAC ID: 5496701195 Enrollment ID: I20050325000105 |
| Provider Name | Seema Maddali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467498972 PECOS PAC ID: 7810944246 Enrollment ID: I20050502001014 |
| Provider Name | Christopher A Pippert |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730138488 PECOS PAC ID: 4183523913 Enrollment ID: I20050518000215 |
| Provider Name | Todd W Walter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467428433 PECOS PAC ID: 3375519077 Enrollment ID: I20050615000324 |
| Provider Name | Davis R Sand |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104839364 PECOS PAC ID: 2567498546 Enrollment ID: I20050712000026 |
| Provider Name | Janell R Haiwick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427024181 PECOS PAC ID: 4082639463 Enrollment ID: I20051014000260 |
| Provider Name | Mark H Winholtz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659325066 PECOS PAC ID: 1951214089 Enrollment ID: I20051116000912 |
| Provider Name | Bryant R Beehler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235166992 PECOS PAC ID: 3577584788 Enrollment ID: I20051215000657 |
| Provider Name | Pamela L Brett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508832254 PECOS PAC ID: 4688683097 Enrollment ID: I20060412000696 |
| Provider Name | Malcolm B Parker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700854544 PECOS PAC ID: 9436164258 Enrollment ID: I20060725000286 |
| Provider Name | Bridey L Boese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982676615 PECOS PAC ID: 8426051954 Enrollment ID: I20060822000549 |
| Provider Name | Patricia I Rasmussen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194758102 PECOS PAC ID: 1456244136 Enrollment ID: I20061106000504 |
| Provider Name | Deepika Kakani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710029483 PECOS PAC ID: 5395849913 Enrollment ID: I20070409000268 |
| Provider Name | Timothy M Peterson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306055355 PECOS PAC ID: 9436250099 Enrollment ID: I20070726000205 |
| Provider Name | Joseph D Scuderi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043292253 PECOS PAC ID: 7517957988 Enrollment ID: I20070830000695 |
| Provider Name | Charles Wolfe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376594457 PECOS PAC ID: 6901994979 Enrollment ID: I20071109000123 |
| Provider Name | Kristi K Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437345808 PECOS PAC ID: 4183704224 Enrollment ID: I20080102000488 |
| Provider Name | Mary B Trombley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457534679 PECOS PAC ID: 4880778943 Enrollment ID: I20080227000711 |
| Provider Name | Catherine A Moe |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1306065768 PECOS PAC ID: 7618056615 Enrollment ID: I20080501000588 |
| Provider Name | Cheryl D Huls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992952444 PECOS PAC ID: 2264509918 Enrollment ID: I20080922000265 |
| Provider Name | Joseph V Lazzara |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609844166 PECOS PAC ID: 9032287149 Enrollment ID: I20081002000345 |
| Provider Name | Amy K Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366540155 PECOS PAC ID: 2668520875 Enrollment ID: I20090428000107 |
| Provider Name | Anita M Strei |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235191149 PECOS PAC ID: 5496668105 Enrollment ID: I20090701000076 |
| Provider Name | Debra G Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326000241 PECOS PAC ID: 0840341921 Enrollment ID: I20090701000110 |
| Provider Name | Kene Gina Ogbogu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447424247 PECOS PAC ID: 8123173572 Enrollment ID: I20090908000602 |
| Provider Name | Nathaniel Reuter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457479446 PECOS PAC ID: 8921199373 Enrollment ID: I20090924000337 |
| Provider Name | Scott H Schultz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033170246 PECOS PAC ID: 3274679097 Enrollment ID: I20091008000551 |
| Provider Name | Jane C Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447214515 PECOS PAC ID: 6305982984 Enrollment ID: I20091013000258 |
| Provider Name | David M Ross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538135843 PECOS PAC ID: 0840388203 Enrollment ID: I20100203000786 |
| Provider Name | Kathryn S Kramer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487615605 PECOS PAC ID: 3971647496 Enrollment ID: I20100222000941 |
| Provider Name | Christian P Schmidt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497745152 PECOS PAC ID: 1052455318 Enrollment ID: I20100224000643 |
| Provider Name | Darin D Willardsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346230034 PECOS PAC ID: 5395880462 Enrollment ID: I20100302000141 |
| Provider Name | Jean-marie R Ebrahimi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801863022 PECOS PAC ID: 9335278167 Enrollment ID: I20100603000455 |
| Provider Name | Ann T Mcintosh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487615100 PECOS PAC ID: 4688703457 Enrollment ID: I20100603000905 |
| Provider Name | Joyce L Carlson |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1831338664 PECOS PAC ID: 8527182534 Enrollment ID: I20100827000459 |
| Provider Name | Shih-an Hsieh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003076290 PECOS PAC ID: 1557485497 Enrollment ID: I20100830001137 |
| Provider Name | Craig P Mckay |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164528055 PECOS PAC ID: 8527098433 Enrollment ID: I20101111000748 |
| Provider Name | Angela R Bentley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053501866 PECOS PAC ID: 5193817369 Enrollment ID: I20110816000564 |
| Provider Name | Berit L Amundson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790009454 PECOS PAC ID: 4789856543 Enrollment ID: I20111020000685 |
| Provider Name | Thad P Larson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477844439 PECOS PAC ID: 8729251095 Enrollment ID: I20111101000727 |
| Provider Name | Amy F Nicolas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619231834 PECOS PAC ID: 1153572219 Enrollment ID: I20121119000460 |
| Provider Name | Lavanya Bhoopathy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891027884 PECOS PAC ID: 4082878012 Enrollment ID: I20121129000449 |
| Provider Name | Sarah J Staff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881944858 PECOS PAC ID: 0345492724 Enrollment ID: I20121211000255 |
| Provider Name | Brandon R Thiemann |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912267642 PECOS PAC ID: 1951554617 Enrollment ID: I20130104000323 |
| Provider Name | Cassandra Jewels Bulau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275891293 PECOS PAC ID: 2668613217 Enrollment ID: I20130725000054 |
| Provider Name | Elsaid Rabie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336427525 PECOS PAC ID: 4183867039 Enrollment ID: I20130826000588 |
| Provider Name | Mary K Holm |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477583664 PECOS PAC ID: 0446349153 Enrollment ID: I20131018000413 |
| Provider Name | Tomasz P Lis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003122151 PECOS PAC ID: 8325273832 Enrollment ID: I20131108000055 |
| Provider Name | James E Malkuch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053747667 PECOS PAC ID: 1850529264 Enrollment ID: I20140110000134 |
| Provider Name | Dexter R Casta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194043034 PECOS PAC ID: 2365566205 Enrollment ID: I20140609001817 |
| Provider Name | Ted H Burningham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174509129 PECOS PAC ID: 4183642754 Enrollment ID: I20141009001582 |
| Provider Name | Misbil F Hagi-salaad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508265984 PECOS PAC ID: 0749401586 Enrollment ID: I20141021001291 |
| Provider Name | Amber D Rossin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518368133 PECOS PAC ID: 7719209865 Enrollment ID: I20141201001671 |
| Provider Name | Kruti J Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043574262 PECOS PAC ID: 7012232218 Enrollment ID: I20150210002426 |
| Provider Name | Mehdi Dastrange |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982967139 PECOS PAC ID: 4880906734 Enrollment ID: I20150706002597 |
| Provider Name | Desmond Brown |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1689080533 PECOS PAC ID: 3779700489 Enrollment ID: I20150819007606 |
| Provider Name | Eric David Hyun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831450170 PECOS PAC ID: 8527374388 Enrollment ID: I20150825004478 |
| Provider Name | Lorant Divald |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275859670 PECOS PAC ID: 7719111020 Enrollment ID: I20151027000535 |
| Provider Name | Robin E Howe |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689774077 PECOS PAC ID: 4284641077 Enrollment ID: I20151221000929 |
| Provider Name | Matthew B Singh |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487029765 PECOS PAC ID: 9638473861 Enrollment ID: I20160209002539 |
| Provider Name | Mark R Martens |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194921973 PECOS PAC ID: 7315236833 Enrollment ID: I20160523000750 |
| Provider Name | Mark Swenson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316064835 PECOS PAC ID: 3971696071 Enrollment ID: I20160712003034 |
| Provider Name | Megan Ann Sangiacomo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578977971 PECOS PAC ID: 3678876570 Enrollment ID: I20160830000565 |
| Provider Name | Gregory M Olszewski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952741050 PECOS PAC ID: 6608096748 Enrollment ID: I20170213002686 |
| Provider Name | Chuong Huu Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164968202 PECOS PAC ID: 7810270956 Enrollment ID: I20170215000653 |
| Provider Name | Tracy A Matros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891234761 PECOS PAC ID: 5496030173 Enrollment ID: I20170320001899 |
| Provider Name | Robert Maurice Payne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184038580 PECOS PAC ID: 3476857798 Enrollment ID: I20170524000107 |
| Provider Name | Alicia Grace Floyd |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033408505 PECOS PAC ID: 2567680713 Enrollment ID: I20170814001669 |
| Provider Name | Alexandra L Malkuch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689186207 PECOS PAC ID: 3476813668 Enrollment ID: I20180208000622 |
| Provider Name | Jill M David Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922513100 PECOS PAC ID: 1254695893 Enrollment ID: I20180507000407 |
| Provider Name | Ronald E Carroll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790821122 PECOS PAC ID: 7315998226 Enrollment ID: I20180530002452 |
| Provider Name | Lee M Haggenjos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003207416 PECOS PAC ID: 6709144892 Enrollment ID: I20180801002195 |
| Provider Name | Paul K Perry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043448095 PECOS PAC ID: 4284888462 Enrollment ID: I20180807002336 |
| Provider Name | Kevin J Dirksen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063992857 PECOS PAC ID: 8527311299 Enrollment ID: I20181025002306 |
| Provider Name | James L Dorn |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104267863 PECOS PAC ID: 1254574049 Enrollment ID: I20181109000404 |
| Provider Name | Merlin W Friesen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063490001 PECOS PAC ID: 0345349049 Enrollment ID: I20190108003094 |
| Provider Name | Jodi L Scott |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073585667 PECOS PAC ID: 9436125978 Enrollment ID: I20190110002363 |
| Provider Name | Tera L Bredeson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922567668 PECOS PAC ID: 6406197938 Enrollment ID: I20190411000079 |
| Provider Name | Douglas P.e. Briggman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962067793 PECOS PAC ID: 7719212752 Enrollment ID: I20190712000033 |
| Provider Name | Jonathon G Marshall |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932561628 PECOS PAC ID: 1254624364 Enrollment ID: I20190718002493 |
| Provider Name | Karissa L Ahlgren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447859517 PECOS PAC ID: 9638583222 Enrollment ID: I20210121002020 |
| Provider Name | Jammie K Klobes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093312159 PECOS PAC ID: 9931513546 Enrollment ID: I20210122000012 |
| Provider Name | Whitney Lynn Bertram-reents |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1134626476 PECOS PAC ID: 7911331509 Enrollment ID: I20210720002361 |
| Provider Name | Samantha J Buck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043986698 PECOS PAC ID: 7416354261 Enrollment ID: I20210922000891 |
| Provider Name | Stephanie Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649944042 PECOS PAC ID: 7012300528 Enrollment ID: I20220204001853 |
| Provider Name | Joshua P Langner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366187296 PECOS PAC ID: 7315327970 Enrollment ID: I20220629002143 |
| Provider Name | Heather Clarson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326443144 PECOS PAC ID: 0840513875 Enrollment ID: I20220912002508 |
| Provider Name | Kristen Elizabeth Beikirch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598328379 PECOS PAC ID: 4082957493 Enrollment ID: I20221011000077 |
| Provider Name | Tyler C Santjer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902520471 PECOS PAC ID: 9436526357 Enrollment ID: I20221109000318 |
| Provider Name | Emily Felzenberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063684702 PECOS PAC ID: 5890872329 Enrollment ID: I20221222002211 |
| Provider Name | Jeffrey T Hunt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245641760 PECOS PAC ID: 9931401478 Enrollment ID: I20240102001117 |