JANELLE L KYLLO (NPI# 1366716102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366716102 |
Entity Type | Individual |
Full Name | JANELLE L KYLLO |
Credential | PA-C |
Practice Address |
1027 Washington Ave Detroit Lakes MN 56501-3409 |
Mailing Address |
1702 University Dr S Fargo ND 58103-4940 |
Practice Telephone | 2188475611 |
Enumeration Date | 2012-02-24 |
Last Update Date | 2018-10-11 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 225XP0200X |
Occupational Therapist Specialization: Pediatrics |
OT-1120 | ID | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Y | 363A00000X | Physician Assistant | 12809 | MN | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1027 WASHINGTON AVE |
City | DETROIT LAKES |
State | MN |
Zip Code | 56501-3409 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063414084 | Janell Kjos | Nurse Practitioner | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2005-08-10 |
1962003277 | Mary C Wiczek | Nurse Practitioner | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2020-11-03 |
1760096481 | Nikki Lynn Oliver | Nurse Practitioner | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2020-09-01 |
1215548680 | Sherri L Softing | Dietitian, Registered | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2020-08-11 |
1841817384 | Rachel D Karlson | Nurse Practitioner | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2020-07-01 |
1063037489 | Caitlin Ann Kumpula | Registered Nurse | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2020-06-11 |
1225662695 | Rebecca D Peterson | Hospitalist | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2020-02-25 |
1548893183 | Katherine A Starbeck | Nurse Practitioner | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2020-02-21 |
1548819519 | Taylor Jones Thooft | Pharmacist | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2019-09-11 |
1437717618 | Connor J Camrud | Physical Therapist | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2019-06-03 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588265649 | Candace Louise Haugtvedt | Pharmacist | 321 Us-10 West, Detroit Lakes, MN 56501 | 2020-11-05 |
1679068407 | Strive Chiropractic Detroit Lakes LLC | Chiropractor | 1852 Nodaway Drive, Detroit Lakes, MN 56501 | 2018-06-25 |
1194215830 | Jordan James Reese | Registered Nurse | 1295 Bay Ridge Dr, Detroit Lakes, MN 56501 | 2018-05-17 |
1992179386 | Compassion House | Substance Abuse Rehabilitation Facility | 811 8th St. Se, Detroit Lakes, MN 56501 | 2015-11-23 |
1720344286 | Lakes Crisis & Resource Center | Clinic/Center | 1339 Pelican Lane, Detroit Lakes, MN 56501 | 2012-04-09 |
1063657120 | Diane Jean Mccormack | Occupational Therapist | 15840 Long Lake Road, Detroit Lakes, MN 56501 | 2008-12-03 |
1588817928 | Darcy Caleb Olson | Counselor | 925 Lake Ave, Detroit Lakes, MN 56501 | 2008-10-29 |
1760651079 | Rapidcare Urgent Care Pllc | Family Medicine | 1361 Wenner Road, Detroit Lakes, MN 56501 | 2008-02-21 |
1427274729 | Jeffrey C Gregory | Psychologist | 910 Lincoln Ave, Detroit Lakes, MN 56501 | 2007-04-17 |
1144364894 | Midwest Vision Centers Inc | Eyewear Supplier (Equipment, not the service) | 830 Washington Avenue, Detroit Lakes, MN 56501 | 2007-02-16 |
Find all providers in zip 56501 |
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 |
---|---|---|---|---|
1003339573 | Sharon Lynn Bolar | Physician Assistant | 14490 E Fox Lake Rd, Detroit Lakes, MN 56501-7111 | 2017-07-17 |
1851319438 | Gary Alan Miller | Physician Assistant | 1361 Wenner Rd, Detroit Lakes, MN 56501-7918 | 2006-07-18 |
1366802290 | Jeremiah Dagel | Physician Assistant | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2016-03-04 |
1073981908 | Christopher Peluso | Physician Assistant | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2015-09-09 |
1770913071 | Erin Marie Chen | Physician Assistant | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2013-11-22 |
1700125796 | Garrett R Penton | Physician Assistant | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2013-02-11 |
1356508139 | Vonda Eidenschink | Physician Assistant | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2008-05-20 |
1942495627 | Chentel Spring Dangerud | Physician Assistant | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2007-09-06 |
1740207380 | Michael Joseph Mcgregor | Physician Assistant | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2006-07-17 |
1225064868 | Kurtis K Motschenbacher | Physician Assistant | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2006-06-24 |
Find all providers in DETROIT LAKES |
City | DETROIT LAKES |
Zip Code | 56501 |
Please comment or provide details below to improve the information on JANELLE L KYLLO.
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.