MRS. KATHI JO TRAVAILLE (NPI# 1255456604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255456604 |
| Entity Type | Individual |
| Full Name | MRS. KATHI JO TRAVAILLE |
| Credential | CRDA |
| Practice Address |
304 Belle Ave Mankato MN 56001-5250 |
| Mailing Address |
605 Hillcrest Ave Ste 130 Owatonna MN 55060-3680 |
| Practice Telephone | 5073448698 |
| Practice Fax Number | 5073448759 |
| Mailing Telephone | 5074510290 |
| Mailing Fax Number | 5074510291 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | A9553 | MN | Dental Providers |
| Street Address |
304 BELLE AVE |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-5250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225014970 | Joseph Frank Foss | Pathology | 304 Belle Ave, Mankato, MN 56001-5250 | 2005-12-15 |
| 1881903524 | Denise M Abrahamson | Licensed Practical Nurse | 304 Belle Ave, Mankato, MN 56001-5250 | 2010-09-29 |
| 1144413782 | Southeastern Minnesota Oral & Maxillofacial Surgery Associates | Clinic/Center | 304 Belle Ave, Mankato, MN 56001-5250 | 2007-08-27 |
| 1356466718 | Shari Lynn Ward | Licensed Practical Nurse | 304 Belle Ave, Mankato, MN 56001-5250 | 2007-03-21 |
| 1316062771 | Alyce Lorayne Konz | Licensed Practical Nurse | 304 Belle Ave, Mankato, MN 56001-5250 | 2007-03-21 |
| 1003931460 | Vicky Lynn Schubbe | Licensed Practical Nurse | 304 Belle Ave, Mankato, MN 56001-5250 | 2007-03-21 |
| 1730165499 | Dennis D Gremel | Pathology | 304 Belle Ave, Mankato, MN 56001-5250 | 2005-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952824948 | Victoriya Lynn Lemke | Dental Assistant | 925 Highway 55 Ste 202, Hastings, MN 55033-3736 | 2017-07-21 |
| 1497061766 | Rose A Malkovich | Dental Assistant | 3657 Minnehaha Ave, Minneapolis, MN 55406-2628 | 2010-08-25 |
| 1255565966 | Ismail Hersi | Dental Assistant | 2801 Park Ave Apt B5, Minneapolis, MN 55407-1330 | 2009-05-08 |
| 1376798173 | Jenny Kohler | Dental Assistant | 1407 6th St S, Stillwater, MN 55082-5707 | 2008-11-20 |
| 1104383611 | Heather Winters | Dental Assistant | 6980 Fairview Rd, Baxter, MN 56425-7836 | 2019-02-21 |
| 1477010981 | Laura Carlson | Dental Assistant | 6980 Fairview Rd, Baxter, MN 56425-7836 | 2019-02-21 |
| 1154855666 | Michelle O'connell | Dental Assistant | 9950 Valley Creek Rd, Woodbury, MN 55125-4883 | 2017-04-12 |
| 1508305731 | Joanne Eileen Wright | Dental Assistant | 30 7th St E, #101, Saint Paul, MN 55101-4914 | 2017-02-21 |
| 1851784854 | Kristine Workman | Dental Assistant | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2015-03-15 |
| 1649663618 | Amanda Reinsbach | Dental Assistant | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2015-03-13 |
| 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.