RUBY BOWERS (NPI# 1184180614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184180614 |
| Entity Type | Individual |
| Full Name | RUBY BOWERS |
| Practice Address |
11850 Blackfoot St Nw Ste 490 Coon Rapids MN 55433-2773 |
| Mailing Address |
11850 Blackfoot St Nw Ste 490 Coon Rapids MN 55433-2773 |
| Practice Telephone | 7634271137 |
| Mailing Telephone | 2182349043 |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-03-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 12857 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
12857 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11850 BLACKFOOT ST NW STE 490 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164737417 | Nicholas James Pruett | Physician Assistant | 11850 Blackfoot St Nw Ste 490, Coon Rapids, MN 55433-2773 | 2010-08-11 |
| 1417432683 | Tammy J Estrem | Physician Assistant | 11850 Blackfoot St Nw Ste 490, Coon Rapids, MN 55433-2773 | 2018-10-03 |
| 1871079004 | Kayla Marie Heyn | Physician Assistant | 11850 Blackfoot St Nw Ste 490, Coon Rapids, MN 55433-2773 | 2018-07-11 |
| 1063907368 | Alyssa Schlenker | Physician Assistant | 11850 Blackfoot St Nw Ste 490, Coon Rapids, MN 55433-2773 | 2018-06-28 |
| 1154685097 | Joseph Robert Kapurch II | Neurological Surgery | 11850 Blackfoot St Nw Ste 490, Coon Rapids, MN 55433-2773 | 2012-06-26 |
| 1477812394 | Timothy James Kovanda | Neurological Surgery | 11850 Blackfoot St Nw Ste 490, Coon Rapids, MN 55433-2773 | 2012-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871079004 | Kayla Marie Heyn | Physician Assistant | 11850 Blackfoot St Nw Ste 490, Coon Rapids, MN 55433-2773 | 2018-07-11 |
| 1023524204 | Chelsie Nicole Horner | Physician Assistant | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2017-12-24 |
| 1457805020 | Amanda Michelle Peterson | Physician Assistant | 11850 Blackfoot St Nw, Ste 300, Coon Rapids, MN 55433-2578 | 2016-08-11 |
| 1104163369 | Krista Marie Skoglund | Physician Assistant | 11850 Blackfoot St Nw, Suite 490, Coon Rapids, MN 55433-2578 | 2013-01-08 |
| 1083641195 | Andrew R Schock | Physician Assistant | 11850 Blackfoot St Nw, Suite 490, Coon Rapids, MN 55433-2578 | 2006-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194120204 | Nathan C Clapper | Physician Assistant | 3580 Arcade St Ste 100, Vadnais Heights, MN 55127-7135 | 2014-10-31 |
| 1003180555 | Elizabeth K Saterenzoller | Physician Assistant | 1015 Marsh Street, Mankato, MN 56002-8673 | 2012-03-01 |
| 1477824472 | Andrea Jo Pitzl | Physician Assistant | 3208 36th Ave Ne, St Anthony, MN 55418-1713 | 2012-01-23 |
| 1447560693 | Jeanine Marie Edstrom | Physician Assistant | 1185 Town Centre Dr Ste 200, Eagan, MN 55123-1343 | 2010-10-20 |
| 1841504792 | Michelle R Aumock | Physician Assistant | 8100 W 78th Street, Ste 230, Edina, MN 55439 | 2010-08-03 |
| 1194042390 | Gerald Frederick Anderson | Physician Assistant | 4060 Haines Rd, #104, Duluth, MN 55811-1746 | 2010-04-27 |
| 1558683904 | Oswaldo Serge | Physician Assistant | 4036 3rd St Nw, Rochester, MN 55901-7564 | 2010-02-25 |
| 1417288945 | Amanda Kay Johnson | Physician Assistant | 201 W Center St Ei-01 Surgical Assistant, Rochester, MN 55902-3003 | 2010-01-22 |
| 1790922755 | Jenelle Cecilia Rock | Physician Assistant | 1950 Northwestern Ave S, Suite 102, Stillwater, MN 55082-7590 | 2009-01-13 |
| 1174775514 | Nathan J Nistler | Physician Assistant | 3580 Arcade Stq, Vadnais Heights, MN 55127-7135 | 2008-10-16 |
| Find all providers with the same taxonomy | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on RUBY BOWERS.
| 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.