ETHAN AXTMAN (NPI# 1407419419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407419419 |
| Entity Type | Individual |
| Full Name | ETHAN AXTMAN |
| Practice Address |
1300 Anne St Nw Bemidji MN 56601-5103 |
| Mailing Address |
Po Box 5074 Sioux Falls SD 57117-5074 |
| Practice Telephone | 2183335000 |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2020-05-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 2472321 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
A145482 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1300 ANNE ST NW |
| City | BEMIDJI |
| State | MN |
| Zip Code | 56601-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922090901 | Marvin R Fetter | Orthopaedic Surgery | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2005-08-17 |
| 1679129555 | Ashley Marie Wavrin | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-08-15 |
| 1649824996 | Angela Halvorson | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-07-25 |
| 1114589348 | Rachel Marie Vesta | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-07-09 |
| 1053895201 | Jarad Syrstad | Physical Therapist | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-09-23 |
| 1851874416 | Kimberly Miller | Physician Assistant | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-09-10 |
| 1780175752 | Billie Jo Dressing | Registered Nurse | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-05-24 |
| 1386142818 | Andrea May Lucca | Social Worker | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-01-30 |
| 1356859979 | Andrew William Rook | Registered Nurse | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-01-17 |
| 1891214466 | Kelley Brooke Olsen | Nurse Anesthetist, Certified Registered | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2017-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1366093841 | Vickie Lynn Matthews | Technician | 1018 Miles Ave Se, Bemidji, MN 56601 | 2019-09-25 |
| 1518443530 | Lindsey Marie Whiting | Registered Nurse | 1300 Anne St, Bemidji, MN 56601 | 2018-07-12 |
| 1801257662 | Meghan Zigrida Paquette | Registered Nurse | 6055 161st Street Nw, Cass Lake, MN 56601 | 2016-03-08 |
| 1144686106 | Northwest Indian Oic | Home Health | 1819 Bemidji Ave N Ste 1, Bemidji, MN 56601 | 2016-01-06 |
| 1831560424 | Laura Hansen, Msw, Licsw Counseling Services, Inc. | Social Worker | 403 4th Street Ne, Suite 110, Bemidji, MN 56601 | 2015-10-08 |
| 1679949028 | Grand St. Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 2312 Bemidji Ave North, Bemidji, MN 56601 | 2015-08-19 |
| 1255717617 | Mary S. Salter, Md Psc | Internal Medicine | 514 Beltrami Ave Nw Suite 102, Bemidji, MN 56601 | 2015-08-07 |
| 1225420615 | Cristin Evans | Counselor | 403 4th Street, Suite 300, Bemidji, MN 56601 | 2015-02-23 |
| 1619367919 | Angela Krom Fournier | Psychologist | 16150 Golden Eagle Court Nw, Eagle Vista Equine Center Inc., Bemidji, MN 56601 | 2015-01-26 |
| Find all providers in zip 56601 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568950129 | Sandy Marie Lafromboise | Nurse Practitioner | 5304 Bemidji Ave N, Bemidji, MN 56601-5709 | 2018-04-28 |
| 1013163922 | Brenda K Amundson | Nurse Practitioner | 1500 Birchmont Dr Ne # 42, Bemidji, MN 56601-2600 | 2008-08-12 |
| 1447351713 | Robin Leach Buchanan | Nurse Practitioner | 800 Bemidji Ave N, Suite 200, Bemidji, MN 56601-3020 | 2006-09-26 |
| 1881618221 | Barbara J Eriksson-capes | Nurse Practitioner | 1100 38th St Nw, Bemidji, MN 56601-5107 | 2006-07-27 |
| 1780662544 | Delayna A Nitz | Nurse Practitioner | 1705 Anne St Nw, Bemidji, MN 56601-6151 | 2006-01-03 |
| 1679129555 | Ashley Marie Wavrin | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-08-15 |
| 1649824996 | Angela Halvorson | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-07-25 |
| 1114589348 | Rachel Marie Vesta | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-07-09 |
| 1205297512 | Alison Elizabeth Hanson | Nurse Practitioner | 1611 Anne St Nw, Bemidji, MN 56601-5114 | 2016-03-14 |
| 1740692482 | Megan Askelson | Nurse Practitioner | 705 5th St Nw Ste B, Bemidji, MN 56601 | 2014-05-29 |
| Find all providers in BEMIDJI | ||||
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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.