GWENDOLYN MARTINIQUE KOSEVICH (NPI# 1013901875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013901875 |
| Entity Type | Individual |
| Full Name | GWENDOLYN MARTINIQUE KOSEVICH |
| Credential | MSN |
| Practice Address |
295 Phalen Blvd Saint Paul MN 55130-2400 |
| Mailing Address |
8170 33rd Ave S # Ms 21110q Minneapolis MN 55425-4516 |
| Practice Telephone | 6514956603 |
| Practice Fax Number | 6514956201 |
| Mailing Telephone | 6514956603 |
| Mailing Fax Number | 9528538727 |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2019-01-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R1237131 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 900 Nicollet Mall, Minneapolis, MN 554032530 | 6126597111 | 6126597101 |
| Street Address |
295 PHALEN BLVD |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55130-2400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811536865 | Kathryn Ann Hill | Occupational Therapist | 295 Phalen Blvd, Saint Paul, MN 55130-2400 | 2019-12-21 |
| 1659854123 | Carla Klassen | Physician Assistant | 295 Phalen Blvd, Saint Paul, MN 55130-2400 | 2018-09-11 |
| 1447747563 | Rishav Aggarwal | Neurological Surgery | 295 Phalen Blvd, Saint Paul, MN 55130-2400 | 2018-04-13 |
| 1528573458 | Nancy Ann Mack | Occupational Therapist | 295 Phalen Blvd, Saint Paul, MN 55130-2400 | 2017-12-14 |
| 1720507254 | Aditi Anil Velankar | Physical Therapist | 295 Phalen Blvd, Saint Paul, MN 55130-2400 | 2017-09-15 |
| 1811419120 | Tamara Roseanne Nascene | Occupational Therapist | 295 Phalen Blvd, Saint Paul, MN 55130-2400 | 2017-07-10 |
| 1922537992 | Jacque Therese Brumm | Nurse Practitioner | 295 Phalen Blvd, Saint Paul, MN 55130-2400 | 2017-06-05 |
| 1811420441 | Zachary Bergman | Surgery | 295 Phalen Blvd, Saint Paul, MN 55130-2400 | 2017-04-10 |
| 1063963577 | Group Health Plan Inc | Durable Medical Equipment & Medical Supplies | 295 Phalen Blvd, Saint Paul, MN 55130-2400 | 2016-10-19 |
| 1265859011 | Adam Sudbeck | Physician Assistant | 295 Phalen Blvd, Saint Paul, MN 55130-2400 | 2014-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904587 | Confident Care LLC | In Home Supportive Care | 1040 Arkwright Street, Saint Paul, MN 55130 | 2018-09-01 |
| 1881015253 | Lucas Bosco Wanga | Psychologist | 715 Edgerton Street, Merrick Community Services, St. Paul, MN 55130 | 2014-01-02 |
| 1174865570 | Sarang Patel | Internal Medicine | 401 Phalen Blvd # 41103d, Saint Paul, MN 55130 | 2013-03-23 |
| 1427394501 | Zongxee Lee | Registered Nurse | 1072 Payne Ave, St. Paul, MN 55130 | 2012-12-18 |
| 1740532753 | One Stop Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 1049 Payne Ave Suite C, St Paul, MN 55130 | 2012-10-15 |
| 1689923997 | Alexis Simmons | Counselor | 402 University Ave East, Suite A-127, Saint Paul, MN 55130 | 2012-08-31 |
| 1689804064 | Group Health Plan, Inc. | Durable Medical Equipment & Medical Supplies | 537 Phalen Blvd, Saint Paul, MN 55130 | 2009-07-21 |
| 1477756534 | Chad Everett Christensen | Chiropractor | 1073 Payne Ave, Saint Paul, MN 55130 | 2007-06-07 |
| 1922219021 | Qwik Urgent Care Clinic | Family Medicine | 1239 Payne Avenue, Saint Paul, MN 55130 | 2007-05-24 |
| 1275743981 | Yia Vang | Technician | 1100 Arkwright St., St. Paul, MN 55130 | 2007-05-23 |
| Find all providers in zip 55130 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013535426 | Chesley Stanley | Nurse Practitioner | 3113 Fletcher Dr, Saint Paul, VA 24283-3763 | 2020-07-13 |
| 1568002160 | Amazing Grace Health | Nurse Practitioner | 625 Snelling Ave N Ste A, Saint Paul, MN 55104-5585 | 2020-01-10 |
| 1265907083 | Lillia Budd | Nurse Practitioner | 225 Smith Ave N - Suite 400, Mail Route 65400, Saint Paul, MN 55102 | 2018-10-08 |
| 1710403118 | Liv-on Family Care Center, Pa | Nurse Practitioner | 1210 County Road J Ste 102, Saint Paul, MN 55127-6826 | 2017-08-17 |
| 1225588668 | Katie-anne Swenson | Nurse Practitioner | 2550 University Ave W Ste 325s, Saint Paul, MN 55114-1903 | 2016-10-10 |
| 1619329133 | Lamin Jaiteh | Nurse Practitioner | 2550 University Ave W Ste 325-s, Saint Paul, MN 55114-1052 | 2016-07-08 |
| 1457746281 | Florence Fon | Nurse Practitioner | 5 County Road B E Ste 3, Saint Paul, MN 55117-1945 | 2015-03-30 |
| 1639576994 | Angela Denise Lentz | Nurse Practitioner | 178 9th St E Ste 300, Saint Paul, MN 55101-2577 | 2014-12-01 |
| 1548506405 | Mandi Sue Counters | Nurse Practitioner | 14635 Pennock Ave Ste 200, Saint Paul, MN 55124-6587 | 2012-12-21 |
| 1528315470 | Amanda Jeanne Carroll | Nurse Practitioner | 1358 Kent St, Saint Paul, MN 55117-4226 | 2012-08-09 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55130 |
Please comment or provide details below to improve the information on GWENDOLYN MARTINIQUE KOSEVICH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.