JENNIFER PETRICIG (NPI# 1578003364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578003364 |
| Entity Type | Individual |
| Full Name | JENNIFER PETRICIG |
| Practice Address |
7237 Forestview Ln N Maple Grove MN 55369-5501 |
| Mailing Address |
613 Western St Anoka MN 55303-2004 |
| Practice Telephone | 7634208595 |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-02-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MN | Other Service Providers |
| Street Address |
7237 FORESTVIEW LN N |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369-5501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871667444 | Ross Alexander Bergfalk | Massage Therapist | 7237 Forestview Ln N, Maple Grove, MN 55369-5501 | 2006-11-17 |
| 1023660982 | Pamela January | Massage Therapist | 7237 Forestview Ln N, Maple Grove, MN 55369-5501 | 2019-07-11 |
| 1417480104 | Rachel Roller | Mechanotherapist | 7237 Forestview Ln N, Maple Grove, MN 55369-5501 | 2017-04-10 |
| 1134585482 | Darin John Wagner | Chiropractor | 7237 Forestview Ln N, Maple Grove, MN 55369-5501 | 2015-12-31 |
| 1346625837 | Paul Broman | Chiropractor | 7237 Forestview Ln N, Maple Grove, MN 55369-5501 | 2015-07-25 |
| 1104228584 | Andrea White | Massage Therapist | 7237 Forestview Ln N, Maple Grove, MN 55369-5501 | 2014-09-17 |
| 1679711469 | Chadd Burckhardt | Chiropractor | 7237 Forestview Ln N, Maple Grove, MN 55369-5501 | 2009-02-02 |
| 1710125562 | Broman Chiropractic Clinic Pa | Chiropractor | 7237 Forestview Ln N, Maple Grove, MN 55369-5501 | 2009-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164548590 | Platinum Health, LLC | Specialist | 9825 Hospital Dr., Suite 105, Maple Grove, MN 55369-7073 | 2007-03-21 |
| 1053860056 | Fargo Health, Inc. | Specialist | 9325 Upland Ln N, Suite 205, Maple Grove, MN 55369-4200 | 2016-10-02 |
| 1437560141 | Roger S Hogue Md Pa | Specialist | 7365 Kirkwood Ct N, Suite 120, Maple Grove, MN 55369-4721 | 2014-05-15 |
| 1104176205 | Anesthesia Associates, Pllc | Specialist | 9645 Grove Cir N Ste 250, Maple Grove, MN 55369 | 2012-09-16 |
| 1326398561 | Interventional Spine and Pain Physicians, Pa | Specialist | 9645 Grove Cir N Ste 200, Maple Grove, MN 55369 | 2012-09-14 |
| 1992947501 | Gregory Pippert Md, Pa | Specialist | 7270 Forestview Ln N, Suite 225, Maple Grove, MN 55369-5546 | 2009-03-27 |
| 1568560688 | Gary Bernard Rosen | Specialist | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2006-09-20 |
| 1265460117 | Joseph James Pietrafitta | Specialist | 9325 Upland Ln N, Suite 205, Maple Grove, MN 55369-4470 | 2006-06-29 |
| 1891723078 | Steven James Waisbren | Specialist | 9325 Upland Ln N, Suite 205, Maple Grove, MN 55369-4470 | 2006-06-28 |
| 1780649665 | Specialists In General Surgery | Specialist | 9825 Hospital Dr, Suite 105, Maple Grove, MN 55369-4479 | 2006-04-20 |
| Find all providers in MAPLE GROVE | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
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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.