JULIE S CRONK (NPI# 1467406843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1467406843 |
Entity Type | Individual |
Full Name | JULIE S CRONK |
Credential | M.D. |
Practice Address |
3555 Willow Lake Blvd Suite 240 Saint Paul MN 55110-5131 |
Mailing Address |
60 Plato Blvd E Saint Paul MN 55107-1827 |
Practice Telephone | 6517700110 |
Practice Fax Number | 6517700134 |
Mailing Telephone | 6512091600 |
Mailing Fax Number | 6512919169 |
Enumeration Date | 2006-05-20 |
Last Update Date | 2020-09-28 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207N00000X | Dermatology | 42849 | MN | Allopathic & Osteopathic Physicians |
Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
42849 | MN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | 077077900 | 05 |
Street Address |
3555 WILLOW LAKE BLVD SUITE 240 |
City | SAINT PAUL |
State | MN |
Zip Code | 55110-5131 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104046820 | Jessica A Healy | Dermatology | 3555 Willow Lake Blvd, Suite 240, Saint Paul, MN 55110-5131 | 2007-04-26 |
1043329220 | Jerry Wayne Stanke | Dermatology | 3555 Willow Lake Blvd, Suite 240, Saint Paul, MN 55110-5131 | 2006-08-30 |
1831208685 | Robert Clifton Anderson | Dermatology | 3555 Willow Lake Blvd, Suite 240, Saint Paul, MN 55110-5131 | 2006-08-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467071084 | St. Catherine University School Based Health Clinic | Nurse Practitioner | 5045 Division Ave, White Bear Lake, MN 55110 | 2020-04-14 |
1922450618 | Lisa Marie Thatcher | Podiatrist | 4653 White Bear Pkwy., St. Paul, MN 55110 | 2016-07-06 |
1558725598 | White Bear Dentists, PC | Dentist | 1970 Buerkle Road, White Bear Lake, MN 55110 | 2016-04-06 |
1124486246 | Julie Blaske | Counselor | 1310 Hwy 96 E, Suite 200, White Bear Lake, MN 55110 | 2016-02-03 |
1851761514 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1920 Buerkle Rd, White Bear Lake, MN 55110 | 2015-10-06 |
1821496969 | Leah Eichmiller | Acupuncturist | 2183 3rd Street, C/o Indulge Salon, White Bear Lake, MN 55110 | 2014-12-05 |
1447672084 | Ashley Rath | Chiropractor | 1247 Gun Club Rd., White Bear Lake, MN 55110 | 2014-01-16 |
1790121291 | Advanced Medical Home Care, LLC | Home Health | 2555 County Road E East, Suite 101, White Bear Lake, MN 55110 | 2013-05-11 |
1134468465 | Emergency Physicians Professional Association | Clinic/Center | 1159 E. County Road E, Vadnais Heights, MN 55110 | 2013-02-06 |
1639444284 | Rebecca Lynn Blaede | Counselor | 4858 Banning Avenue, White Bear Lake, MN 55110 | 2012-03-15 |
Find all providers in zip 55110 |
Taxonomy Code | 207ND0101X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
Specialization | MOHS-Micrographic Surgery |
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770115610 | Dermatology Partners Pllc | Dermatology | 4041 28th St Nw Ste 200, Rochester, MN 55901-7943 | 2020-02-09 |
1023460243 | Ji Won Ahn | Dermatology | 200 1st St Sw, Rochester, MN 55905-5902 | 2016-07-12 |
1487018263 | Sama Kassira Carley | Dermatology | 200 1st St Sw, Rochester, MN 55905-0001 | 2016-04-07 |
1740532340 | Clarus Dermatology Pa | Dermatology | 2603 39th Ave Ne, Suite D-202, Minneapolis, MN 55421-4372 | 2012-10-05 |
1598925513 | Ian A Maher | Dermatology | 909 Fulton St Se, Minneapolis, MN 55455 | 2008-06-12 |
1235323585 | Bart Theodore Endrizzi | Dermatology | 420 Delaware St Se, Minneapolis, MN 55455-0341 | 2007-08-29 |
1730206541 | Michael Robert Campoli | Dermatology | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2007-03-25 |
City | SAINT PAUL |
Zip Code | 55110 |
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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.