FAITH BOUTTELL (NPI# 1609425966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609425966 |
| Entity Type | Individual |
| Full Name | FAITH BOUTTELL |
| Practice Address |
25423 Heims Lake Circle Wyoming MN 55092 |
| Practice Telephone | 6514901738 |
| Mailing Telephone | 6514901738 |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers |
| Street Address |
25423 HEIMS LAKE CIRCLE |
| City | WYOMING |
| State | MN |
| Zip Code | 55092 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696022 | Wyoming Family Dental | Dentist | 5378 East Viking Blvd., Wyoming, MN 55092 | 2020-10-12 |
| 1851909436 | Matthew Rohlf | Dentist | 5378 E Viking Blvd, Wyoming, MN 55092 | 2020-07-20 |
| 1669013280 | Christina Marie Orde | Technician | 4855 261st Street, Wyoming, MN 55092 | 2019-10-04 |
| 1275875031 | Fairview Express Care | Clinic/Center | 5130 Fairview Blvd, Suite 101, Wyoming, MN 55092 | 2013-03-20 |
| 1023385242 | St. Croix Orthopaedics, P.a. | Durable Medical Equipment & Medical Supplies | 5200 Fairview Blvd., Wyoming, MN 55092 | 2011-11-17 |
| 1902851876 | Tamara Piroska Petrac-halatsis | Obstetrics & Gynecology | 5200 Fairview Boulevard, Ob/gyn Department, Wyoming, MN 55092 | 2006-05-22 |
| 1023502697 | Molly Levy | Nurse Practitioner | 5200 Fairview Blvd, Wyoming, MN 55092 | 2018-06-18 |
| 1588028955 | Kevin Anthony Brueske | Pediatrics | 5200 Fairview Blvd, Wyoming, MN 55092 | 2016-04-11 |
| 1376922070 | Carli Lynn Ceder | Physical Therapist | 5130 Fairview Blvd, Wyoming, MN 55092 | 2015-05-27 |
| 1497192066 | Matthew David Torgeson | Surgery | 5200 Fairview Blvd, Wyoming, MN 55092 | 2013-05-22 |
| Find all providers in zip 55092 | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669013280 | Christina Marie Orde | Technician | 4855 261st Street, Wyoming, MN 55092 | 2019-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255959581 | Ready To Care | Technician | 7420 Unity Ave N Ste 110c, Brooklyn Park, MN 55443-3161 | 2020-07-13 |
| 1437789781 | Anita Mae Thompson | Technician | 41306 120th St, Waseca, MN 56093 | 2020-01-24 |
| 1548809007 | Yeev Thoj | Technician | 1896 3rd St E, Saint Paul, MN 55119-3417 | 2020-01-02 |
| 1578102026 | Ronald Dean Luckhardt | Technician | 5617 Cleary Road Nw, Anoka, MN 55303-9624 | 2020-01-02 |
| 1356986475 | Barbro E Strom Langley | Technician | 16901 River View Cir, Big Lake, MN 55309 | 2019-11-13 |
| 1821631391 | Patrice Marie Curtiss | Technician | 23792 Winckler Road, Grand Rapids, MN 55744 | 2019-10-28 |
| 1770126674 | Abigail Larson | Technician | 5328 Hwy 7, Culver, MN 55779 | 2019-10-23 |
| 1265074173 | Madeline Teresa Stoltz | Technician | 219 Plum Run, Le Sueur, MN 56058 | 2019-10-11 |
| 1740822642 | Maxine L. Mccormick | Technician | 40 Irvine Park, Saint Paul, MN 55102-2413 | 2019-10-11 |
| 1255973319 | Connie Rettig | Technician | 908 North Shore Drive, Forest Lake, MN 55025 | 2019-10-10 |
| 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.