MS. ABBY ROSE ROTH (NPI# 1134465065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134465065 |
| Entity Type | Individual |
| Full Name | MS. ABBY ROSE ROTH |
| Credential | NP-C |
| Practice Address |
4241 Johnny Cake Ridge Rd Eagan MN 55122-2235 |
| Mailing Address |
2240 E 42nd St Minneapolis MN 55407-3049 |
| Practice Telephone | 8663892727 |
| Mailing Telephone | 5072694279 |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2012-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R-161224-8 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881077089 | Abby R Roth | Behavioral Analyst | 10926 S Tryon St Ste E, Charlotte, NC 28273-4154 | 2015-07-07 |
| Street Address |
4241 JOHNNY CAKE RIDGE RD |
| City | EAGAN |
| State | MN |
| Zip Code | 55122-2235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821623190 | Melissa Ann Hulscher | Pharmacist | 4241 Johnny Cake Ridge Rd, Eagan, MN 55122-2235 | 2020-03-07 |
| 1043729932 | Shakyra Rivers | Nurse Practitioner | 4241 Johnny Cake Ridge Rd, Eagan, MN 55122-2235 | 2017-09-24 |
| 1801315585 | Josephat Muthiga Mutahi | Nurse Practitioner | 4241 Johnny Cake Ridge Rd, Eagan, MN 55122-2235 | 2017-09-14 |
| 1093235533 | Joann Kay Williams Ruppert | Nurse Practitioner | 4241 Johnny Cake Ridge Rd, Eagan, MN 55122-2235 | 2017-06-26 |
| 1033451232 | Brooke Schroepfer | Physician Assistant | 4241 Johnny Cake Ridge Rd, Eagan, MN 55122-2235 | 2013-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651753 | Alvaro Jesus Jimenez Aguilar | Registered Nurse | 1764 Silver Bell Rd, Eagan, MN 55122 | 2019-01-02 |
| 1194213280 | Amherst H. Wilder Foundation | Lodging | Lincoln Place, 1997 Gold Trail, Eagan, MN 55122 | 2018-04-25 |
| 1831541168 | Mackenzie Lea Kerber | Counselor | 3410 Federal Dr Suite 101, Eagan, MN 55122 | 2016-07-11 |
| 1285010074 | Eagan Pointe Senior Living | Assisted Living Facility | 4232 Black Hawk Road, Eagan, MN 55122 | 2015-08-04 |
| 1700268828 | Kara Beth Rose | Specialist/Technologist | 4560 Cinnamon Ridge Trail, Eagan, MN 55122 | 2015-06-25 |
| 1558740803 | Samuel Johnson | Physician Assistant | 2901 Metro Drive, Suite 527, Bloomington, MN 55122 | 2015-05-20 |
| 1528451028 | Judi Ross Holistic Therapy, LLC | Marriage & Family Therapist | 4141 Old Sibley Memorial Highway, Eagan, MN 55122 | 2015-03-09 |
| 1447649637 | Leah Ruth Streitman | Physician Assistant | 3460 Washington Dr Ste 200, Eagan, MN 55122 | 2015-01-12 |
| 1518362193 | Cedar Valley Center for Child & Family Therapy | Preferred Provider Organization | 3460 Washington Dr., Suite 110, Eagan, MN 55122 | 2014-10-25 |
| 1316351703 | Wecare Dental of Eagan P.c | Clinic/Center | 1625 Lena Court Suite 100, Eagan, MN 55122 | 2014-06-13 |
| Find all providers in zip 55122 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568078616 | Joanna Kay Rehm | Nurse Practitioner | 3025 Eagandale Pl Apt 338, Eagan, MN 55121-1236 | 2020-09-23 |
| 1700172350 | Mary Christine Mcnabney | Nurse Practitioner | 610 Opperman Drive, D4 Health Center, Your Wellbeing Health Center, Eagan, MN 55123 | 2011-06-22 |
| 1639369325 | Sue Ann Vruno | Nurse Practitioner | 3708 Cardinal Way, Eagan, MN 55123-2237 | 2007-07-28 |
| 1710929062 | Lisa Eleanor Fahey-bleick | Nurse Practitioner | 4178 Knob Dr, Suite A, Eagan, MN 55122-2888 | 2006-06-12 |
| 1326009630 | Lisa Bojado | Nurse Practitioner | 2854 Highway 55 Ste 130, Eagan, MN 55121-1447 | 2006-03-29 |
| 1255964458 | Amy Eileen Anderson | Nurse Practitioner | 1440 Duckwood Dr, Eagan, MN 55122-1451 | 2020-02-16 |
| 1245876622 | Darrian Michelle Fisher | Nurse Practitioner | 2620 Eagan Woods Dr, Eagan, MN 55121-1138 | 2019-11-21 |
| 1043729932 | Shakyra Rivers | Nurse Practitioner | 4241 Johnny Cake Ridge Rd, Eagan, MN 55122-2235 | 2017-09-24 |
| 1801315585 | Josephat Muthiga Mutahi | Nurse Practitioner | 4241 Johnny Cake Ridge Rd, Eagan, MN 55122-2235 | 2017-09-14 |
| 1386160166 | Kristine Mary Cody | Nurse Practitioner | 3305 Central Park Village Dr, Eagan, MN 55121-7707 | 2017-08-14 |
| Find all providers in EAGAN | ||||
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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.