MRS. COURTNEY MAE WITTROCK (NPI# 1336688175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336688175 |
| Entity Type | Individual |
| Full Name | MRS. COURTNEY MAE WITTROCK |
| Credential | PA-C |
| Practice Address |
1900 Centracare Cir Suite 2300 Saint Cloud MN 56303-5000 |
| Practice Telephone | 3206543630 |
| Practice Fax Number | 3202295142 |
| Mailing Telephone | 3206543630 |
| Mailing Fax Number | 3202295142 |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1900 CENTRACARE CIR SUITE 2300 |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-5000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407858020 | Centracare Clinic | Clinic/Center | 1900 Centracare Cir, Centracare Clinic Health Plaza, Saint Cloud, MN 56303-5000 | 2005-08-12 |
| 1245845007 | Kayla Bolland-hillesheim | Counselor | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2020-09-09 |
| 1255976387 | Victoria Sybilla Hadley | Nurse Practitioner | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2019-11-13 |
| 1952945560 | Amanda Rae Schwartz | Physician Assistant | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2019-11-06 |
| 1467095166 | Cameron Svihla | Physician Assistant | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2019-10-25 |
| 1912540188 | Zoe Boehmer | Dietitian, Registered | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2019-10-21 |
| 1669033429 | Haley Vonbank | Physical Therapist | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2019-06-24 |
| 1396302741 | Karen Ann Reisdorf | Dietitian, Registered | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2019-05-21 |
| 1316500648 | Carrilyn Bechtold | Occupational Therapist | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2019-04-22 |
| 1770049066 | Clinton James Billhorn | Physician Assistant | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2019-02-12 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992944656 | Laura M Gunder Mcclary | Physician Assistant | 3301 Buckingham Way, Saint Cloud, FL 34772-8747 | 2009-02-19 |
| 1497360259 | David Scott Levy | Physician Assistant | 2029 Hickory Tree Rd, Saint Cloud, FL 34772-8906 | 2020-09-09 |
| 1164055505 | Anne Elizabeth Cullen | Physician Assistant | 251 County Road 120, Saint Cloud, MN 56303-4872 | 2020-02-13 |
| 1770139420 | Maranda Kate Heinks | Physician Assistant | 1900 Centracare Cir Ste 2400, Saint Cloud, MN 56303-5000 | 2019-08-16 |
| 1063935955 | Amanda Marilyn Michalski | Physician Assistant | 1301 33rd St S, Saint Cloud, MN 56301-9668 | 2017-07-21 |
| 1558798090 | Ila Anita Morin | Physician Assistant | 3100 17th St, Saint Cloud, FL 34769-6021 | 2013-09-30 |
| 1063852085 | Dimitrios N Minadakis | Physician Assistant | 251 County Road 120, Saint Cloud, MN 56303-4872 | 2013-07-05 |
| 1063765774 | Sierra A Hobbs | Physician Assistant | 3100 17th St, Saint Cloud, FL 34769-6021 | 2012-10-18 |
| 1942589080 | Susan Michelle Luetmer | Physician Assistant | 3701 12th St N, Suite 100, Saint Cloud, MN 56303-2255 | 2011-08-08 |
| 1881863124 | Cassandra A. Amiot | Physician Assistant | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2008-02-20 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
Please comment or provide details below to improve the information on MRS. COURTNEY MAE WITTROCK.
| 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.