JEANNE LOUISE LUCK (NPI# 1093733768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093733768 |
| Entity Type | Individual |
| Full Name | JEANNE LOUISE LUCK |
| Other Name | JEANNE LOUISE MILLER |
| Credential | RN, MSN, CFNP |
| Practice Address |
8290 University Ave Ne Suite 200 Fridley MN 55432-1847 |
| Mailing Address |
6465 Wayzata Blvd Suite 900 St Louis Park MN 55426-1728 |
| Practice Telephone | 7637869543 |
| Practice Fax Number | 7637863320 |
| Mailing Telephone | 9525125600 |
| Mailing Fax Number | 9525125650 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-07-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R105398-8 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PREFERREDONE | 969991017871 | 01 | |
| MEDICA | 114567 | 01 | |
| BLUECROSS BLUESHIELD | 134K1LU | 01 | |
| MN | 941319700 | 05 | |
| UCARE | 123231E949 | 01 | |
| HEALTHPARTNERS | HP30388 | 01 |
| Street Address |
8290 UNIVERSITY AVE NE SUITE 200 |
| City | FRIDLEY |
| State | MN |
| Zip Code | 55432-1847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588638514 | Amy C Lindell | Physician Assistant | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2006-02-15 |
| 1568999126 | Peter D Fitzgerald | Physician Assistant | 8290 University Ave Ne, Fridley, MN 55432-1847 | 2017-05-15 |
| 1912358219 | Kelli Michelle Cannata | Physician Assistant | 8290 University Ave Ne, Ste 200, Fridley, MN 55432-1847 | 2016-06-28 |
| 1245614247 | Jenna Evelyn Walker | Occupational Therapist | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2015-07-20 |
| 1891101838 | Katie Mclaughlin | Physician Assistant | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2014-07-10 |
| 1477973246 | Taylor James Ridley | Orthopaedic Surgery | 8290 University Ave Ne, Fridley, MN 55432-1847 | 2014-04-21 |
| 1730515719 | Bryan D Dejarlais | Physical Therapist | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2013-09-23 |
| 1205277571 | Nea Rae Bennington | Physician Assistant | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2013-07-15 |
| 1699010132 | Seth David Engberg | Physical Therapist | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2012-12-11 |
| 1760726053 | Kristina L Withers | Physical Therapist | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2012-11-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
| 1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
| 1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
| 1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
| 1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
| 1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
| Find all providers in zip 55432 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921769 | Inas Muhidine | Nurse Practitioner | 7362 University Ave Ne # S206, Fridley, MN 55432-3142 | 2020-04-22 |
| 1811247786 | Katherine Hentges | Nurse Practitioner | 550 Osborne Rd Unity Hospital, Fridley, MN 55432-2718 | 2012-09-18 |
| 1528047321 | Amy S Lewis | Nurse Practitioner | 7590 Lyric Ln Ne, Fridley, MN 55432-3251 | 2006-01-11 |
| 1578058038 | Jessica Stewart | Nurse Practitioner | 500 Osborne Rd Ne Ste 255, Fridley, MN 55432-2768 | 2018-06-27 |
| 1497162721 | Laura Lorraine Hilker | Nurse Practitioner | 6341 University Ave Ne, Fridley, MN 55432-4946 | 2014-07-18 |
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|---|---|---|---|---|
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| 1063010304 | Kalie R Mccauley | Nurse Practitioner | 11452 Brook Rd Nw, Elk River, MN 55330-8739 | 2020-10-09 |
| 1659978930 | Sarah Jean Mudge | Nurse Practitioner | 350 Harbor Dr, Duluth, MN 55802-2600 | 2020-10-08 |
| 1285231621 | Karlu Dorleh | Nurse Practitioner | 14151 Territorial Rd Unit 212, Maple Grove, MN 55369-5725 | 2020-10-08 |
| 1447857669 | Kimberly Dawn Bursch-tewalt | Nurse Practitioner | 11884 237th Ave Nw, Elk River, MN 55330-8255 | 2020-10-01 |
| 1639786312 | Peter Wahl | Nurse Practitioner | 4652 Lyndale Ave S, Minneapolis, MN 55419-5302 | 2020-09-28 |
| 1568078616 | Joanna Kay Rehm | Nurse Practitioner | 3025 Eagandale Pl Apt 338, Eagan, MN 55121-1236 | 2020-09-23 |
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| 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.