JANELLE L KYLLO


Address: 1027 Washington Ave, Detroit Lakes, MN 56501-3409
Phone: 2188475611

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 1027 WASHINGTON AVE
City DETROIT LAKES
State MN
Zip Code 56501-3409

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City DETROIT LAKES
Zip Code 56501

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Dataset Information

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.

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