MINUTECLINIC DIAGNOSTIC PA (NPI# 1194797894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194797894 |
| Entity Type | Organization |
| Organization Name | MINUTECLINIC DIAGNOSTIC PA |
| Practice Address |
2017 Coon Rapids Blvd Nw Coon Rapids MN 55433-4121 |
| Mailing Address |
Po Box 772 Minuteclinic Credentialing Mc2295 Woonsocket RI 02895-0784 |
| Practice Telephone | 8663892727 |
| Practice Fax Number | 4014063539 |
| Mailing Telephone | 8663892727 |
| Mailing Fax Number | 4014063539 |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2020-03-26 |
| Authorized Official Name | DEBORAH PINCINCE (ADMINISTRATOR) |
| Authorized Official Telephone | 4017703813 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICARE RAILROAD | DO1667 | 01 |
| Street Address |
2017 COON RAPIDS BLVD NW |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-4121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245866342 | Ma Lourdes Yepes Dela Cruz | Pharmacist | 2017 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-4121 | 2020-03-20 |
| 1851927438 | Syed S Ahmed | Pharmacist | 2017 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-4121 | 2020-03-16 |
| 1952534802 | Misty Schmitz | Chiropractor | 2017 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-4121 | 2009-08-26 |
| 1992991129 | Vu Ngoc Nguyen | Nurse Practitioner | 2017 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-4121 | 2007-09-20 |
| 1518066810 | Grand St Paul Cvs LLC | Pharmacy | 2017 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-4121 | 2006-09-22 |
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659763928 | Teresa Cyrus | Nurse Practitioner | 354 123rd Cir Nw, Coon Rapids, MN 55448-2677 | 2015-02-24 |
| 1891029872 | Paul T. Linson | Nurse Practitioner | 9055 Springbrook Dr Nw # Mw, Coon Rapids, MN 55433-5841 | 2009-09-24 |
| 1841285848 | Laurie Marha King | Nurse Practitioner | 12900 Riverdale Dr Nw, Coon Rapids, MN 55448-1063 | 2005-09-15 |
| 1346887585 | Andria Sammon | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2019-12-06 |
| 1619452455 | Kati Jo Kaushal | Nurse Practitioner | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2018-09-27 |
| 1588146732 | Erika Janet Hachey | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2018-09-04 |
| 1992220594 | Laila Summer Akhter | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2017-08-04 |
| 1568856599 | David Thomson | Nurse Practitioner | 4040 Coon Rapids Blvd Nw, 120, Coon Rapids, MN 55433-4567 | 2015-03-27 |
| 1356739940 | Julia Kathryn Botzet | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2015-01-05 |
| 1366849788 | Stephanie Hecklin | Nurse Practitioner | 4040 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-4568 | 2014-12-01 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on MINUTECLINIC DIAGNOSTIC PA.
| 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.