KATHERINE WAHL (NPI# 1609384973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609384973 |
| Entity Type | Individual |
| Full Name | KATHERINE WAHL |
| Practice Address |
13980 Northdale Blvd Rogers MN 55374 |
| Mailing Address |
13980 Northdale Blvd Rogers MN 55374-2147 |
| Practice Telephone | 7634281920 |
| Practice Fax Number | 6128742916 |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2018-11-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0200X |
Registered Nurse Specialization: Pediatrics |
2230470 | MN | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
6045 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 701 Park Ave, Minneapolis, MN 554151623 | 6128733000 |
| Street Address |
13980 NORTHDALE BLVD |
| City | ROGERS |
| State | MN |
| Zip Code | 55374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760459259 | Mary E. Mahony | Pediatrics | 13980 Northdale Blvd, Rogers, MN 55374-2147 | 2006-03-02 |
| 1376805770 | Noelle Ellis | Pediatrics | 13980 Northdale Blvd, Rogers, MN 55374-2147 | 2012-06-12 |
| 1063481513 | William N. Kunau | Nurse Practitioner | 13980 Northdale Blvd, Rogers, MN 55374-2147 | 2006-03-16 |
| 1629046412 | Naomi C. Palmer | Pediatrics | 13980 Northdale Blvd, Rogers, MN 55374-2147 | 2006-03-09 |
| 1649247859 | Wade M. Larson | Pediatrics | 13980 Northdale Blvd, Rogers, MN 55374-2147 | 2006-03-07 |
| 1700853397 | Andrew W. Larson | Pediatrics | 13980 Northdale Blvd, Rogers, MN 55374-2147 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609335835 | Rebecca Loehrer | Nurse Practitioner | 21370 Ste 210 John Milless Dr., Rogers, MN 55374 | 2019-03-18 |
| 1255722328 | Samantha Colai | Marriage & Family Therapist | 21307 John Milless Drive, Suite 106, Rogers, MN 55374 | 2015-02-11 |
| 1437559648 | Jamie Mosley | Counselor | 2100 Rogers Drive, Suite 200, Rogers, MN 55374 | 2014-08-26 |
| 1295145886 | Marisa Kolasa | Massage Therapist | 22290 Oakdale Drive, Rogers, MN 55374 | 2014-05-05 |
| 1871878165 | Derek P Doty Dc Inc | Chiropractor | 21410 136th Ave N, Suite 105a, Rogers, MN 55374 | 2011-10-18 |
| 1912205865 | Michelle Cheryl Finnegan-larson | Registered Nurse | 21308 John Milless Drive, Rogers, MN 55374 | 2011-03-02 |
| 1639402571 | Ascend Family Institute | Community/Behavioral Health | 20980 Rogers Drive, #400, Rogers, MN 55374 | 2009-09-10 |
| 1275738403 | Nicole M Clements | Physician Assistant | 1355 Rogers Drive, Rogers, MN 55374 | 2007-06-18 |
| 1558566166 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 21455 John Milless Drive, Rogers, MN 55374 | 2007-06-15 |
| 1811062854 | Randall Alvin Hohbein | Pharmacist | 21351 John Milless Drive, Rogers Drug, Rogers, MN 55374 | 2006-11-22 |
| Find all providers in zip 55374 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215333075 | Lisa Lavon Fields | Nurse Practitioner | 5434 W Walsh Ln, Rogers, AR 72758-8946 | 2014-11-06 |
| 1497749428 | Scarlet Denise Travis | Nurse Practitioner | 500 S 52nd St, Rogers, AR 72758-8600 | 2005-09-06 |
| 1619961646 | Marilou Shreve | Nurse Practitioner | 900 S 52nd St, 200, Rogers, AR 72758-8637 | 2005-09-06 |
| 1225292592 | Karyn Denise Sherar | Nurse Practitioner | 1233 W Poplar St, Rogers, AR 72756-4245 | 2008-07-15 |
| 1063481513 | William N. Kunau | Nurse Practitioner | 13980 Northdale Blvd, Rogers, MN 55374-2147 | 2006-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518587120 | Amanda Joy Dominik | Nurse Practitioner | 4411 Arden View Ct, Arden Hills, MN 55112-1944 | 2020-04-23 |
| 1881245504 | Hailey Prescott | Nurse Practitioner | 2450 Riverside Avenue Se, Minneapolis, Mn, MN 55454-1400 | 2019-09-24 |
| 1598317570 | Elisabeth Palmquist | Nurse Practitioner | 12000 Elm Creek Blvd N Ste 250, Maple Grove, MN 55369-7164 | 2019-07-10 |
| 1538644562 | Angela Ashton | Nurse Practitioner | 345 Smith Ave N Ste 404, Saint Paul, MN 55102-2346 | 2018-09-25 |
| 1558865295 | Meghan Kerry Deyo | Nurse Practitioner | 1804 7th St W Ste 200, Saint Paul, MN 55116-2300 | 2018-03-19 |
| 1336642131 | Caitlin Anna Lingbeck | Nurse Practitioner | 14001 Ridgedale Dr #100, Minnetonka, MN 55305-1781 | 2018-03-18 |
| 1740799246 | Maya Bastian | Nurse Practitioner | 12220 Travois Rd, Eden Prairie, MN 55347-4241 | 2017-09-27 |
| 1821523028 | Robin Marie Parker | Nurse Practitioner | 14135 Cedar Avenue South, Suite 100, Apple Valley, MN 55124 | 2017-04-25 |
| 1538691043 | Jenifer Flegel | Nurse Practitioner | 963 Robert St S, West Saint Paul, MN 55118-1446 | 2017-04-03 |
| 1154796811 | Megan Stark | Nurse Practitioner | 2805 Campus Dr Ste 235, Plymouth, MN 55441-2678 | 2015-12-07 |
| Find all providers with the same taxonomy | ||||
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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.