MR. THEODORE YNGVE KORSGREN III


Address: 1717 W. Cowles St., Fairbanks, AK 99701-5903
Phone: 9074516682

MR. THEODORE YNGVE KORSGREN III (NPI# 1497942585) 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) 1497942585
Entity Type Individual
Full Name MR. THEODORE YNGVE KORSGREN III
Credential LPN
Practice Address 1717 W. Cowles St.
Fairbanks
AK 99701-5903
Practice Telephone 9074516682
Mailing Telephone 9074516682
Enumeration Date 2007-10-02
Last Update Date 2012-12-03
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 164W00000X Licensed Practical Nurse 5364 AK Nursing Service Providers

Office Location

Street Address 1717 W. COWLES ST.
City FAIRBANKS
State AK
Zip Code 99701-5903

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811986037 Jonathan R. Starr Internal Medicine 1717 W. Cowles St., Fairbanks, AK 99701-5926 2005-10-20
1821340142 Kristen M Sublett Advanced Practice Midwife 1717 W. Cowles St., Fairbanks, AK 99701 2012-10-10
1881943447 Karen Fedelem Dentist 1717 W. Cowles St., Fairbanks, AK 99701-5926 2012-08-29
1508972043 Brian Robb Physician Assistant 1717 W. Cowles St., Fairbanks, AK 99701-5903 2006-08-21
1912983800 William Frank Catelli II Dentist 1717 W. Cowles St., Chief Andrew Isaac Health Center Room 2379a, Fairbanks, AK 99701-4899 2005-12-21
1669462206 Nigel George Wappett Obstetrics & Gynecology 1717 W. Cowles St., Fairbanks, AK 99701-5903 2005-10-25

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659984987 Resource Center for Parents & Children, Inc. Social Worker 726 26th Ave, Suite #2, Fairbanks, AK 99701 2020-08-26
1134738982 Aaron Paul Sarauer Behavior Technician 3121 Lathrop St., Fairbanks, AK 99701 2020-07-28
1437715505 Fabienne Rose Marie Siddall Case Manager/Care Coordinator 122 1st Avenue, Fairbanks, AK 99701 2019-05-14
1902461957 Jacqueline Marie Rahm Counselor Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 2019-05-06
1821588989 Corrie Wilson Nurse Practitioner 1025 Barnette Street, Fairbanks, AK 99701 2018-05-15
1922519305 Sarishma Sangeeta Lal Registered Nurse 815 2nd Ave Ste 122, Fairbanks, AK 99701 2017-10-12
1245690569 Christine L Simko Naturopath 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 2016-02-29
1932581600 Jennifer Davis Registered Nurse 1025 West Barnette St., Fairbanks, AK 99701 2015-06-18
1700272705 John D. Zipperer Jr Md, LLC Clinic/Center 751 Old Richardson Hwy., Fairbanks, AK 99701 2015-04-07
1578957460 Mara Justine Becker Physician Assistant 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 2015-03-27
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Taxonomy Information

Taxonomy Code 164W00000X
Grouping Nursing Service Providers
Classification Licensed Practical Nurse

Taxonomy Definition

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1902247778 Prentiss Burke Licensed Practical Nurse 1223 27th Ave, Fairbanks, ALASKA 99701 2013-07-09
1790020204 Misty Morna Nickoli Licensed Practical Nurse 1717 West Cowels Street, Fairbanks, AK 99701 2012-12-10
1437446549 Essie Theresa Johnson Licensed Practical Nurse 540 4th Ave, 100, Fairbanks, AK 99701-4714 2011-07-09
1073848586 Elizabeth Marie Doddridge Licensed Practical Nurse 1015 Smallwood Trl, Fairbanks, AK 99712-3124 2009-10-16
1093048613 Eun Jung Moore Licensed Practical Nurse 3350 Thomas St, Spc 100, Fairbanks, AK 99709-3828 2009-09-14
1255511895 Jamie Dewayne Noble Licensed Practical Nurse 1717 West Cowles, Fairbanks, AK 99701-5903 2007-11-12
1376172585 Lucinda Dowdy Licensed Practical Nurse 1717 W Cowles St, Fairbanks, AK 99701-5926 2020-04-08
1790339695 Gary Eaker Licensed Practical Nurse 1717 W Cowles St, Fairbanks, AK 99701-5926 2019-07-29
1134771751 Sharon Elemento Egana-cabolis Licensed Practical Nurse 650 Younker Ct, Fairbanks, AK 99701-7586 2019-07-13
1396397394 Tamara Lu Thompson Licensed Practical Nurse 650 Younker Ct, Fairbanks, AK 99701-7586 2019-07-10
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Competitor

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City FAIRBANKS
Zip Code 99701

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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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