ANNETTE M HAVLICEK (NPI# 1093037699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093037699 |
| Entity Type | Individual |
| Full Name | ANNETTE M HAVLICEK |
| Credential | CMT |
| Practice Address |
1756 Ridgewood Ave White Bear Township MN 55110 |
| Mailing Address |
1756 Ridgewood Ave White Bear Township MN 55110-5835 |
| Practice Telephone | 6514000884 |
| Mailing Telephone | 6514000884 |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2019-08-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | Other Service Providers | ||
| Y | 225700000X | Massage Therapist | 00006347 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1756 RIDGEWOOD AVE |
| City | WHITE BEAR TOWNSHIP |
| State | MN |
| Zip Code | 55110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467071084 | St. Catherine University School Based Health Clinic | Nurse Practitioner | 5045 Division Ave, White Bear Lake, MN 55110 | 2020-04-14 |
| 1922450618 | Lisa Marie Thatcher | Podiatrist | 4653 White Bear Pkwy., St. Paul, MN 55110 | 2016-07-06 |
| 1558725598 | White Bear Dentists, PC | Dentist | 1970 Buerkle Road, White Bear Lake, MN 55110 | 2016-04-06 |
| 1124486246 | Julie Blaske | Counselor | 1310 Hwy 96 E, Suite 200, White Bear Lake, MN 55110 | 2016-02-03 |
| 1851761514 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1920 Buerkle Rd, White Bear Lake, MN 55110 | 2015-10-06 |
| 1821496969 | Leah Eichmiller | Acupuncturist | 2183 3rd Street, C/o Indulge Salon, White Bear Lake, MN 55110 | 2014-12-05 |
| 1447672084 | Ashley Rath | Chiropractor | 1247 Gun Club Rd., White Bear Lake, MN 55110 | 2014-01-16 |
| 1790121291 | Advanced Medical Home Care, LLC | Home Health | 2555 County Road E East, Suite 101, White Bear Lake, MN 55110 | 2013-05-11 |
| 1134468465 | Emergency Physicians Professional Association | Clinic/Center | 1159 E. County Road E, Vadnais Heights, MN 55110 | 2013-02-06 |
| 1639444284 | Rebecca Lynn Blaede | Counselor | 4858 Banning Avenue, White Bear Lake, MN 55110 | 2012-03-15 |
| Find all providers in zip 55110 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417379 | Amanda R Deowdat | Massage Therapist | 7515 Lyndale Ave S, Richfield, MN 55423-4091 | 2020-11-04 |
| 1902405459 | Ferencz Mihaly Vincze Turcean | Massage Therapist | 1703 Snelling Ave N, Falcon Heights, MN 55113-5725 | 2020-10-25 |
| 1447859467 | Amdemichael Retta | Massage Therapist | 1260 Larpenteur Ave W Apt 320, Saint Paul, MN 55113-6324 | 2020-10-21 |
| 1851999478 | John David Haugmo | Massage Therapist | 125 W Lincoln Ave, Fergus Falls, MN 56537-2152 | 2020-10-15 |
| 1720686298 | Jessica Marie Quast | Massage Therapist | 601 Central Ave W Ste 102, Saint Michael, MN 55376-9711 | 2020-10-15 |
| 1861009185 | Miesha Nicole Lewis | Massage Therapist | 3759 Thomas Ave N, Minneapolis, MN 55412-1840 | 2020-09-30 |
| 1588271928 | Cyarra Monique Swanson | Massage Therapist | 2708 Blaisdell Ave Apt B, Minneapolis, MN 55408-1524 | 2020-09-29 |
| 1932716347 | Susan Helen Lundquist | Massage Therapist | 5901 Omaha Ave N Ste 115, Stillwater, MN 55082-6477 | 2020-09-29 |
| 1568078228 | Jasie Barbour | Massage Therapist | 13036 Europa Trl N, Hugo, MN 55038-4410 | 2020-09-18 |
| 1902411648 | Dakota Lee Hain | Massage Therapist | 1121 Jackson St Ne Ste 119, Minneapolis, MN 55413-1597 | 2020-09-10 |
| Find all providers with the same taxonomy | ||||
| City | WHITE BEAR TOWNSHIP |
| Zip Code | 55110 |
Please comment or provide details below to improve the information on ANNETTE M HAVLICEK.
| 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.