BECKY JO BURDICK (NPI# 1366461840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366461840 |
| Entity Type | Individual |
| Full Name | BECKY JO BURDICK |
| Credential | PA-C |
| Practice Address |
1185 Town Centre Dr Ste 100 Eagan MN 55123-1188 |
| Mailing Address |
710 Commerce Dr Ste 200 Woodbury MN 55125-4925 |
| Practice Telephone | 6519685200 |
| Practice Fax Number | 6519685903 |
| Mailing Telephone | 6519685042 |
| Mailing Fax Number | 6519685904 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-06-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 9606 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1185 TOWN CENTRE DR STE 100 |
| City | EAGAN |
| State | MN |
| Zip Code | 55123-1188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427038371 | Eric A Khetia | Orthopaedic Surgery | 1185 Town Centre Dr Ste 100, Eagan, MN 55123-1188 | 2006-01-18 |
| 1881822203 | Samuel R Olson | Physical Therapist | 1185 Town Centre Dr Ste 100, Eagan, MN 55123-1188 | 2009-06-24 |
| 1104053198 | Allison V Mikota | Occupational Therapist | 1185 Town Centre Dr Ste 100, Eagan, MN 55123-1188 | 2009-06-17 |
| 1316195258 | Stephanie Lynne Kinsella | Physical Therapist | 1185 Town Centre Dr Ste 100, Eagan, MN 55123-1188 | 2008-09-04 |
| 1710164330 | Elizabeth Bangs | Physician Assistant | 1185 Town Centre Dr Ste 100, Eagan, MN 55123-1188 | 2008-01-25 |
| 1548306202 | Nicholas Joseph Wills | Orthopaedic Surgery | 1185 Town Centre Dr Ste 100, Eagan, MN 55123-1188 | 2007-01-29 |
| 1619988193 | Sean Quentin Lynch | Physical Therapist | 1185 Town Centre Dr Ste 100, Eagan, MN 55123-1188 | 2006-08-10 |
| 1740238476 | Sarah Louise Lehnert | Family Medicine | 1185 Town Centre Dr Ste 100, Eagan, MN 55123-1188 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053828467 | Hilltop Family Chiropractic Center Pa | Chiropractor | 1121 Town Centre Drive Suite 202, Eagan, MN 55123 | 2018-01-08 |
| 1922452507 | Jacob Zimmerman | Counselor | 3450 O'leary Ln., Eagan, MN 55123 | 2016-04-20 |
| 1316320971 | K-squared Fitness, L.L.C. | Public Health or Welfare | 1100 Cliff Rd, Eagan, MN 55123 | 2015-07-01 |
| 1346683687 | Joshua M Dorn | Allergy & Immunology | 3460 Promenade Ave, Eagan, MN 55123 | 2013-04-16 |
| 1700172350 | Mary Christine Mcnabney | Nurse Practitioner | 610 Opperman Drive, D4 Health Center, Your Wellbeing Health Center, Eagan, MN 55123 | 2011-06-22 |
| 1033353669 | Todd Borstad | Social Worker | 3450 O'leary Lane, Eagan, MN 55123 | 2009-04-27 |
| 1821025271 | Mngi Endoscopy LLC | Clinic/Center | 1185 Town Centre Drive, Eagan, MN 55123 | 2006-06-28 |
| 1780620120 | Cindy Eileen Wood | Audiologist | 3440 Oleary Lane, 240, Eagan, MN 55123 | 2006-06-22 |
| 1609845742 | Jeffery R Dichter | Internal Medicine | 849 Govern Circle, Saint Paul, MN 55123 | 2006-03-14 |
| 1891269155 | Elise Broderick Quam | Social Worker | 3450 Oleary Ln, Eagan, MN 55123 | 2019-01-18 |
| Find all providers in zip 55123 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371789 | Kamini Bose Sundar Bose | Physician Assistant | 781 Elrene Ct, Eagan, MN 55123-1233 | 2019-11-20 |
| 1568960292 | Omar Fernandes | Physician Assistant | Healthpartners Eagan Clinic, 1654 Diffley Road Ste 100 Mail Stop 34701a, Eagan, MN 55122-2237 | 2018-01-29 |
| 1447649637 | Leah Ruth Streitman | Physician Assistant | 3460 Washington Dr Ste 200, Eagan, MN 55122 | 2015-01-12 |
| 1649328121 | Jennifer Marie Kulus | Physician Assistant | Fairview Urgent Care - Eagan, 1440 Duckwood Drive, Eagan, MN 55122 | 2007-01-08 |
| 1902875818 | Bryan C Sternberg | Physician Assistant | 2620 Eagan Woods Dr Ste 100, Eagan, MN 55121-1138 | 2006-03-14 |
| 1396307450 | Laura Fisher | Physician Assistant | 1400 Corporate Center Curv, Eagan, MN 55121-1373 | 2019-06-28 |
| 1194275552 | Ronneil Aviles | Physician Assistant | 1654 Diffley Rd, Eagan, MN 55122 | 2016-10-10 |
| 1568806958 | Jessica Lynn Cicero | Physician Assistant | 2700 Vikings Cir, Eagan, MN 55121 | 2013-04-29 |
| 1033451232 | Brooke Schroepfer | Physician Assistant | 4241 Johnny Cake Ridge Rd, Eagan, MN 55122-2235 | 2013-03-26 |
| 1306149539 | Kathryn Susan Eisenmenger Fuentes | Physician Assistant | 2854 Highway 55, Suite 130, Eagan, MN 55121-2156 | 2010-12-09 |
| Find all providers in EAGAN | ||||
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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.