BLAKE HUNTER CEDARLEAF (NPI# 1154967156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154967156 |
| Entity Type | Individual |
| Full Name | BLAKE HUNTER CEDARLEAF |
| Credential | PA-C |
| Practice Address |
1406 6th Ave N Saint Cloud MN 56303-1900 |
| Mailing Address |
16832 Linden Ave Grasston MN 55030-4506 |
| Practice Telephone | 3202512700 |
| Mailing Telephone | 6515289173 |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2019-11-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
13252 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1406 6TH AVE N |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-1900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336149939 | Ralph E Fedor | Radiology | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2005-07-26 |
| 1558962399 | Amanda Lee King | Nurse Practitioner | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-11-06 |
| 1912512302 | Fadumo Hassan | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-09-11 |
| 1083228092 | Kristin Deneille Hazeman | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1901 | 2020-09-07 |
| 1508477845 | Taylor Dean Olson | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-08-11 |
| 1407467749 | Traci Jo Salveson | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-08-11 |
| 1487264164 | Cameron Charles Hendrickson | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-08-06 |
| 1154931475 | Megan Ann Brown | Nurse Practitioner | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-08-01 |
| 1326657255 | Amanda J Dircks | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-07-27 |
| 1003439241 | Mary Elizabeth Amundson | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194272401 | James E Bradley II | Physician Assistant | 4944 Oakway Dr, Saint Cloud, FL 34771-7974 | 2016-09-02 |
| 1356835433 | Taylor Ann Ellis | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2736 | 2018-06-21 |
| 1437672482 | Lee Ann Misstishin | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2017-07-21 |
| 1447795380 | Yen Gia Nguyen | Physician Assistant | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2017-01-02 |
| 1356895817 | Steven Lindblom | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2736 | 2016-08-12 |
| 1831580356 | Alan Voegele | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2015-02-05 |
| 1902151228 | Julian Richard Luetmer | Physician Assistant | 1200 6th Ave N, Centra Care Clinic, Saint Cloud, MN 56303-2735 | 2012-07-24 |
| 1710294855 | Abdelkader Ryan Nachit | Physician Assistant | 2906 17th St, Saint Cloud, FL 34769-6006 | 2010-09-10 |
| 1326370271 | Zoe Jamila Gonzales-rabathaly | Physician Assistant | 2801 17th St Unit 202, Saint Cloud, FL 34769-4939 | 2010-02-03 |
| 1770509663 | Jeffrey Scott Trimble | Physician Assistant | 1200 6th Ave N, Centra Care Clinic, Saint Cloud, MN 56303-2735 | 2006-07-14 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
Please comment or provide details below to improve the information on BLAKE HUNTER CEDARLEAF.
| 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.