MARTIN MICHAEL MCNICHOLS (NPI# 1184235723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184235723 |
| Entity Type | Individual |
| Full Name | MARTIN MICHAEL MCNICHOLS |
| Practice Address |
700 30th Ave S Moorhead MN 56560-4926 |
| Practice Telephone | 2183312668 |
| Practice Fax Number | 2183312674 |
| Mailing Telephone | 2183312668 |
| Mailing Fax Number | 2183312674 |
| Enumeration Date | 2020-08-16 |
| Last Update Date | 2020-08-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 812474 | MN | Student, Health Care |
| Street Address |
700 30TH AVE S |
| City | MOORHEAD |
| State | MN |
| Zip Code | 56560-4926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235469826 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 700 30th Ave S, Moorhead, MN 56560-4926 | 2010-01-05 |
| 1528679164 | Lynne Rita Anseth | Pharmacist | 700 30th Ave S, Moorhead, MN 56560-4926 | 2020-08-16 |
| 1194002188 | Susan Ann Hedemark | Pharmacist | 700 30th Ave S, Moorhead, MN 56560-4926 | 2011-11-04 |
| 1548546096 | Nancy Lynn Kagan | Pharmacist | 700 30th Ave S, Moorhead, MN 56560-4926 | 2011-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386298859 | Anna Mckay Fox | Pharmacist | 4000 28th Avenue S, Moorhead, MN 56560 | 2019-08-01 |
| 1972019727 | Michael Wayne Hilliard | Specialist/Technologist | 649 17th St S, Moorhead, MN 56560 | 2017-12-15 |
| 1508217183 | Kristen Johnson | Nurse Practitioner | 801 Belsly Boulevard, Moorhead, MN 56560 | 2016-06-25 |
| 1861877052 | Midwest Mental Health Clinic | Nurse Practitioner | 819 30th Ave S Office 206 Suite B, Moorhead, MN 56560 | 2015-07-29 |
| 1083037709 | Drake Counseling Services, Inc. | Clinic/Center | 715 11th Street North, Suite 204, Moorhead, MN 56560 | 2014-01-31 |
| 1710310917 | Lamar Terrell Hill | Social Worker | 420 Center Ave Ste 102, Moorhead, MN 56560 | 2013-08-12 |
| 1982956140 | Lilac Homes Corporation | Assisted Living Facility | 2615 Parkview Dr, Moorhead, MN 56560 | 2012-10-11 |
| 1487918462 | Paige Joy Hanson | Massage Therapist | 805 14th St. So., Msum Wellness Center, Moorhead, MN 56560 | 2012-06-25 |
| 1972809408 | Cslm, LLC | Assisted Living Facility | 2401 South 11th Street, Moorhead, MN 56560 | 2011-02-01 |
| 1972814846 | Paul Michael Fluto | Pharmacist | 3000 Hwy 10 East, Mooehead, MN 56560 | 2010-06-25 |
| Find all providers in zip 56560 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811452402 | Erik Fischer | Student in an Organized Health Care Education/Training Program | 300 2nd Ave S Apt 310, Moorhead, MN 56560-2651 | 2019-02-07 |
| 1053885608 | Logan Twigg | Student in an Organized Health Care Education/Training Program | 1711 6th St S, Moorhead, MN 56560-3438 | 2019-01-16 |
| 1891214672 | Jae Borgen | Student in an Organized Health Care Education/Training Program | 11 4th St S Apt 103, Moorhead, MN 56560-2608 | 2017-09-13 |
| 1083153035 | Sydney Skye Klein | Student in an Organized Health Care Education/Training Program | 1730 40th Ave S, Apt 310, Moorhead, MN 56560-7911 | 2017-02-22 |
| 1568901379 | Shunichi Takitsu | Student in an Organized Health Care Education/Training Program | 920 18 1/2 St S, Apt. 1, Moorhead, MN 56560-3194 | 2017-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154921047 | Liesa Clare Erickson | Student in an Organized Health Care Education/Training Program | 100 Elizabeth St Apt 416, Duluth, MN 55803-2643 | 2020-10-29 |
| 1639779804 | Chelsie Meemken | Student in an Organized Health Care Education/Training Program | 505 Bluebird Ct, Sartell, MN 56377-1633 | 2020-10-27 |
| 1134729486 | Anna R Spiczka | Student in an Organized Health Care Education/Training Program | 10689 108th Ave N, Hanover, MN 55341-4124 | 2020-10-27 |
| 1558961003 | Maren Elizabeth Iverson | Student in an Organized Health Care Education/Training Program | 1 Veterans Dr # 160, Minneapolis, MN 55417-2309 | 2020-10-26 |
| 1275132003 | Faizo A Hersi | Student in an Organized Health Care Education/Training Program | 9700 International Dr Suite 300, Bloomington, MN 55425 | 2020-10-22 |
| 1467059048 | Ashli Willow Boehm | Student in an Organized Health Care Education/Training Program | 1920 Turning Leaf Ln Sw, Alexandria, MN 56308-4662 | 2020-10-06 |
| 1174130421 | Carolyne Copley | Student in an Organized Health Care Education/Training Program | 226 2nd St Sw, Rochester, MN 55905-0001 | 2020-09-29 |
| 1023624483 | Katherine Hailey Lake | Student in an Organized Health Care Education/Training Program | 16415 Temple Dr, Minnetonka, MN 55345-3431 | 2020-09-21 |
| 1235745027 | Andrew Ryan Mcnamara | Student in an Organized Health Care Education/Training Program | 1015 Lowry Ave Ne Apt 3, Minneapolis, MN 55418-3727 | 2020-09-17 |
| 1740895770 | Arielle Johnson | Student in an Organized Health Care Education/Training Program | 1162 Thomas Ave, Saint Paul, MN 55104-2538 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
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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.