MS. AGNES LIEM (NPI# 1508097247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508097247 |
| Entity Type | Individual |
| Full Name | MS. AGNES LIEM |
| Credential | CPNP-PC, AE-C |
| Practice Address |
10 Missile Ave Minot Afb ND 58705-5003 |
| Mailing Address |
194 Missile Ave Minot Afb ND 58701 |
| Practice Telephone | 7017235138 |
| Practice Fax Number | 6097549195 |
| Mailing Telephone | 7017235138 |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2016-04-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 026.0042618 | VT | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 601494-1 | NY | Nursing Service Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
R43064 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
F382111-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10 MISSILE AVE |
| City | MINOT AFB |
| State | ND |
| Zip Code | 58705-5003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427031673 | 5th Medical Group | Military/U.S. Coast Guard Pharmacy | 10 Missile Ave, Minot Afb, ND 58705-5003 | 2005-11-22 |
| 1952936825 | Dylan M Morales | Military Health Care Provider | 10 Missile Ave, Minot Afb, ND 58705-5003 | 2020-03-11 |
| 1598127862 | Thomas Wagoner | Pediatrics | 10 Missile Ave, Minot Afb, ND 58705-5003 | 2016-03-24 |
| 1093142275 | Aaron D Geyer | Physician Assistant | 10 Missile Ave, Minot Afb, ND 58705-5003 | 2013-10-02 |
| 1649605072 | Jared Jon Solomon | Psychiatry & Neurology | 10 Missile Ave, Minot Afb, ND 58705 | 2013-09-04 |
| 1023457256 | Matthew Wayne Greene | Family Medicine | 10 Missile Ave, Minot Afb, ND 58705-5003 | 2013-06-20 |
| 1013253228 | Kelsey Gene Broome | Physician Assistant | 10 Missile Ave, Minot Afb, ND 58705-5003 | 2012-12-14 |
| 1033491121 | Patrick Mccue | Physician Assistant | 10 Missile Ave, Minot Afb, ND 58705-5003 | 2011-09-14 |
| 1760764393 | 5th Medical Group | Military Hospital | 10 Missile Ave, Minot Afb, ND 58705-5003 | 2011-09-09 |
| 1366754400 | Dfas-jfll/in | Military Hospital | 10 Missile Ave, Minot Afb, ND 58705-5003 | 2010-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265093900 | Coty Winn | Student in an Organized Health Care Education/Training Program | Minot Afb Medical Group, 194 Missile Avenue, Minot Afb, ND 58705 | 2019-06-24 |
| 1144717596 | Angela Kennedy | Social Worker | 5 Mdg 194 Missile Avenue, Minot Afb, ND 58705 | 2018-04-20 |
| 1386064780 | Desiree Avedon Aaron-barber | Licensed Practical Nurse | Minot Va Cboc, Minot Air Force Base, Minot, ND 58705 | 2014-04-24 |
| 1366771644 | Melanie Renee Roserie | Social Worker | 194 Missile Avenue, Minot Afb - 5 Mdg Mental Health Clinic, Minot, ND 58705 | 2009-12-15 |
| 1255565289 | Javier Alberto Padial | Pediatrics | 194 Missle Ave., Minot Afb, Apo, AA 58705 | 2009-05-05 |
| 1184694127 | Michelle Joy Fundingsland | Dietitian, Registered | 201 Missile Ave, Minot Afb, ND 58705 | 2006-01-24 |
| 1306404645 | Yongke Tan | Pharmacist | 194 Missile Avenue, Minot Afb, ND 58705 | 2019-06-02 |
| 1689106320 | Priscilla Barrio | Student in an Organized Health Care Education/Training Program | 194 Missile Ave, Minot Afb, ND 58705 | 2017-03-31 |
| 1881953602 | Casey Simon Brock | Physician Assistant | 194 Missile Avenue, Minot Air Force Base, ND 58705 | 2012-05-14 |
| 1154618973 | Brian Grant Kay | Social Worker | 194 Missile Ave, Minot, ND 58705 | 2011-06-30 |
| Find all providers in zip 58705 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134611197 | Christina Faye Love | Nurse Practitioner | 5th Medical Group, 5mdos/sgop, Minot Afb, ND 58704 | 2018-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598232183 | Caitlin Hemquist | Nurse Practitioner | 100 4th St S Ste 308, Fargo, ND 58103-1937 | 2018-11-01 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1326117268 | Sun-mi Chae | Nurse Practitioner | 430 Oxford St. Stop 9025, College of Nursing Room 349, Grand Forks, ND 58202-9025 | 2006-11-07 |
| 1417930835 | Denise Renee Schrader | Nurse Practitioner | 2701 13th Ave S, Fargo, ND 58103-3602 | 2005-11-21 |
| 1114531928 | Emily Janes | Nurse Practitioner | 1701 S 12th St, Bismarck, ND 58504-6644 | 2020-08-31 |
| 1386274918 | Melissa Ann Knopik | Nurse Practitioner | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-01-23 |
| 1285271601 | Jamie Peshek | Nurse Practitioner | 765 W Interstate Ave, Bismarck, ND 58503-0936 | 2019-12-04 |
| 1427603588 | Annelise Sterneman | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-08-06 |
| 1730748948 | Danielle Jo Mullin | Nurse Practitioner | 275 11th St S, Wahpeton, ND 58075-4655 | 2019-06-11 |
| 1801391248 | Sarah Genevieve Paur | Nurse Practitioner | 2701 13th Ave S, Fargo, ND 58103-3602 | 2018-03-27 |
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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.