ELISSA FUNG (NPI# 1104338730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104338730 |
| Entity Type | Individual |
| Full Name | ELISSA FUNG |
| Practice Address |
779 Bielenberg Dr Ste 108 Woodbury MN 55125-4432 |
| Mailing Address |
7373 France Ave S Ste 110 Edina MN 55435-4538 |
| Practice Telephone | 7632318700 |
| Enumeration Date | 2017-11-05 |
| Last Update Date | 2020-01-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
779 BIELENBERG DR STE 108 |
| City | WOODBURY |
| State | MN |
| Zip Code | 55125-4432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
| 1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
| 1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
| 1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
| 1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
| 1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
| 1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
| Find all providers in zip 55125 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518587583 | Amy Marie Lyttle | Physician Assistant | 570 Settlers Ridge Pkwy Unit A305, Woodbury, MN 55129-7509 | 2020-04-20 |
| 1417253212 | Sara Lynn Sterling | Physician Assistant | 217 Radio Dr, Woodbury, MN 55125-5805 | 2011-01-27 |
| 1639486434 | Ariana Zaza | Physician Assistant | 1 2nd St, Woodbury, NY 11797-1310 | 2010-09-01 |
| 1508047127 | Anna E. Ng | Physician Assistant | 17 W Red Bank Ave Ste 205, Woodbury, NJ 08096-1630 | 2007-11-26 |
| 1033399886 | Kristen D Ballenthin | Physician Assistant | 449 Commerce Drive, Woodbury, MN 55125-4872 | 2007-11-09 |
| 1104852094 | Kaitlin Buckner | Physician Assistant | 6043 Hudson Rd Ste 220, Woodbury, MN 55125-1033 | 2006-06-23 |
| 1972540573 | Susan A Murray | Physician Assistant | 1687 Woodlane Dr Ste 103, Woodbury, MN 55125-3046 | 2006-06-01 |
| 1518911247 | Deborah Lee Hinkle | Physician Assistant | Stones River Hospital, 324 Doolittle Road, Woodbury, TN 37190-5041 | 2006-05-19 |
| 1013986611 | Jennifer Susan Ellis | Physician Assistant | 4040 Radio Dr, Woodbury, MN 55129-3237 | 2006-03-16 |
| 1164495016 | Darrel L Cotch | Physician Assistant | 1811 Weir Drive, Suite 355, Woodbury, MN 55125-2273 | 2006-02-10 |
| Find all providers in WOODBURY | ||||
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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.