DR. BRENDA LEE FANDEL (NPI# 1356338339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356338339 |
Entity Type | Individual |
Full Name | DR. BRENDA LEE FANDEL |
Credential | D.C. |
Practice Address |
967 Lake St S Forest Lake MN 55025-2616 |
Practice Telephone | 6514641113 |
Mailing Telephone | 6514641113 |
Enumeration Date | 2005-10-04 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3214 | MN | Chiropractic Providers |
Street Address |
967 LAKE ST S |
City | FOREST LAKE |
State | MN |
Zip Code | 55025-2616 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821400631 | Lisa Marie Forslund | Nurse Practitioner | 967 Lake St S, Forest Lake, MN 55025-2616 | 2014-05-28 |
1639461544 | James Walter Chapman | Chiropractor | 967 Lake St S, Forest Lake, MN 55025-2616 | 2011-05-11 |
1841522166 | Vladimir Joseph Scharafanow | Massage Therapist | 967 Lake St S, Forest Lake, MN 55025-2616 | 2010-02-11 |
1407187511 | Janice Lee James | Nurse Practitioner | 967 Lake St S, Forest Lake, MN 55025-2616 | 2010-01-29 |
1194992131 | Daniel Philip Piper | Chiropractor | 967 Lake St S, Forest Lake, MN 55025-2616 | 2008-05-09 |
1588749642 | Donald Wayne Kjome | Family Medicine | 967 Lake St S, Forest Lake, MN 55025-2616 | 2006-10-26 |
1720097389 | Deborah S Korbitz | Nurse Practitioner | 967 Lake St S, Forest Lake, MN 55025 | 2006-08-05 |
1467403030 | Lakes Area Health Center, Pllc | Clinic/Center | 967 Lake St S, Forest Lake, MN 55025 | 2006-05-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043846173 | Persistence Physical Therapy LLC | Clinic/Center | 2009 W Broadway Ave, Ste 400 Pmb 131, Forest Lake, MN 55025 | 2020-03-20 |
1255973319 | Connie Rettig | Technician | 908 North Shore Drive, Forest Lake, MN 55025 | 2019-10-10 |
1003394479 | Malissa Ann Costanzo | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 844 8th Ave Se, Forest Lake, MN 55025 | 2018-07-30 |
1669754735 | Brent Alan Millard | Pharmacist | 1207 West Broadway Ave, Forest Lake, MN 55025 | 2011-09-15 |
1982842167 | Lakes Center for Youth and Families | Community/Behavioral Health | 20 N Lake Street, Suite 103, Forest Lake, MN 55025 | 2009-01-27 |
1487843355 | Paul Luke Mladnick | Marriage & Family Therapist | 1068 So Lake St, #109, Forest Lake, MN 55025 | 2007-10-17 |
1740477678 | Rita Lynn Scanlan | Occupational Therapist | 604 Ne 1st St, Birchwood Health Care Center, Forest Lake, MN 55025 | 2007-09-25 |
1114053113 | Senior Care Forest Lake, LLC | Skilled Nursing Facility | 604 N.e. First Street, Forest Lake, MN 55025 | 2007-02-26 |
1073672101 | Catharine B Ruther | Dentist | 956 West Broadway, Lakes Dental Clinic, Forest Lake, MN 55025 | 2006-12-06 |
1407914849 | Ervin George Savord | Dentist | 255 Highway 97, Suite 1b, Forest Lake, MN 55025 | 2006-12-05 |
Find all providers in zip 55025 |
Taxonomy Code | 111N00000X |
Grouping | Chiropractic Providers |
Classification | Chiropractor |
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932430907 | Dayspring Family Wellness Center | Chiropractor | 1401 14th Ave Se, Forest Lake, MN 55025-2081 | 2010-01-14 |
1326160003 | Jason Paul Gerard | Chiropractor | 255 Highway 97 Unit 2a, Forest Lake, MN 55025-2687 | 2007-04-04 |
1073642567 | Bracht Chiropractic, P.a. | Chiropractor | 15226 W Freeway Dr Ne, Forest Lake, MN 55025-9433 | 2007-03-02 |
1033244041 | Steven Z Johnson | Chiropractor | 662 Lake St S, Forest Lake, MN 55025-2611 | 2007-02-22 |
1104968742 | David Jeffrey Lewis | Chiropractor | 591 N Shore Dr, Forest Lake, MN 55025-1217 | 2007-02-12 |
1932273133 | Jack Lewis Duncan | Chiropractor | 707 West Broadway, Forest Lake, MN 55025-1408 | 2006-11-20 |
1972674620 | James Allen Laskow | Chiropractor | 822 Lake St S, Forest Lake, MN 55025-2614 | 2006-11-13 |
1568479996 | Mark W Kari | Chiropractor | 824 Lake St S, Forest Lake, MN 55025-2614 | 2006-08-01 |
1619982022 | Kari Clinic of Chiropractic, P.a. | Chiropractor | 368 Lake St S, Forest Lake, MN 55025-2626 | 2006-07-31 |
1598752859 | Richard Vincent Ottomeyer | Chiropractor | 168 Lake St S Ste C, Forest Lake, MN 55025-4401 | 2005-10-03 |
Find all providers in FOREST LAKE |
City | FOREST LAKE |
Zip Code | 55025 |
Please comment or provide details below to improve the information on DR. BRENDA LEE FANDEL.
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.