DR. VANESSA BOERHAVE (NPI# 1639680473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639680473 |
| Entity Type | Individual |
| Full Name | DR. VANESSA BOERHAVE |
| Credential | PSY.D., LP |
| Practice Address |
8611 W Point Douglas Rd S Cottage Grove MN 55016 |
| Mailing Address |
2925 Chicago Ave Minneapolis MN 55407-1321 |
| Practice Telephone | 6514581884 |
| Mailing Telephone | 6122625000 |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2018-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
LP6167 | MN | Behavioral Health & Social Service Providers |
| Street Address |
8611 W POINT DOUGLAS RD S |
| City | COTTAGE GROVE |
| State | MN |
| Zip Code | 55016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831168236 | Naomi P. Tetzlaff | Family Medicine | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2006-03-16 |
| 1154738805 | Emily Sue Raven | Physician Assistant | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016 | 2014-07-15 |
| 1265853220 | Anjanette Finnegan | Pharmacist | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2013-12-18 |
| 1982952909 | Ekaterina Peterson | Physician Assistant | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2012-08-23 |
| 1750648671 | Victoria Chiou | Family Medicine | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2012-04-17 |
| 1568768919 | Allina Health System | Clinic/Center | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2011-02-02 |
| 1285893594 | James P Mantzaris | Family Medicine | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2008-06-03 |
| 1508885914 | Walid A Mikhail | Family Medicine | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2006-07-18 |
| 1972569408 | Alison Mary Peterson | Family Medicine | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2006-04-24 |
| 1851355135 | Allina Health System | Pharmacy | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2006-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073161519 | Kathleen Johnson | Technician | 7436 Hinton Park Ave South, Cottage Grove, MN 55016 | 2019-08-28 |
| 1710473434 | Cg Care Center, LLC. | Skilled Nursing Facility | 6993 80th Street South, Cottage Grove, MN 55016 | 2018-07-05 |
| 1235532771 | Lydia Sirucek | Nurse Practitioner | 8611 E Point Douglas Rd, Cottage Grove, MN 55016 | 2014-09-29 |
| 1366859746 | Home Care Service Providers Inc. | Home Health | 9635 Hamlet Ave, Cottage Grove, MN 55016 | 2014-07-17 |
| 1942622089 | Wal-mart Stores, Inc. | Technician/Technologist | 9300 East Point Douglas Rd S, Cottage Grove, MN 55016 | 2014-01-08 |
| 1255770962 | Southside At The Cottage Grove Site | Family Medicine | 8454 East Point Douglas Road, Cottage Grove, MN 55016 | 2013-06-17 |
| 1710222088 | Santori Chiropractic Center, LLC | Chiropractor | 7155 80th Street So, Cottage Grove, MN 55016 | 2012-11-28 |
| 1609151414 | Kenneth Nworah Okafor | Pharmacist | 7015 East Point Douglas Road, Cottage Grove, MN 55016 | 2011-10-13 |
| 1134432925 | Elizabeth Frances Rezek | Social Worker | 8813 Hale Ave S, Cottage Grove, MN 55016 | 2010-07-21 |
| 1841420882 | Mark Joseph Mangine | Physical Therapist | 6936 Pine Arbor Dr S Ste 150, Cottage Grove, MN 55016 | 2009-07-24 |
| Find all providers in zip 55016 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376995100 | Haran Kingstan | Psychologist | 8451 E Point Douglas Rd S, Cottage Grove, MN 55016-3331 | 2016-07-05 |
| 1215211362 | Katrina Samlaska | Psychologist | 8451 E Point Douglas Rd S, Cottage Grove, MN 55016-3331 | 2011-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899291 | Charlotte Mae Gerth Haanen | Psychologist | 2805 Cliff Rd E, Burnsville, MN 55337-4095 | 2020-10-17 |
| 1386251148 | Andrew Charles Weis | Psychologist | 158 Water St N Ste 1, Northfield, MN 55057-2125 | 2020-09-25 |
| 1861008567 | Natalia V Potapova | Psychologist | 701 Park Ave # S1.110, Minneapolis, MN 55415-1623 | 2020-09-17 |
| 1720691884 | Oluwatosin Alabi | Psychologist | 4124 Quebec Ave N Ste 307, New Hope, MN 55427-1241 | 2020-08-28 |
| 1962014167 | Kate Esterline | Psychologist | 2724 University Ave Se Ste B, Minneapolis, MN 55414-3210 | 2020-08-19 |
| 1013528207 | Stephen Sean Jenkins | Psychologist | 720 Fourth Ave. S., Eastman Hall 305, Saint Cloud, MN 56301 | 2020-08-12 |
| 1699392266 | Jacqueline Suresh Layton | Psychologist | 17324 Glencoe Ave, Lakeville, MN 55044-7429 | 2020-06-30 |
| 1760016109 | Cori Miller | Psychologist | 7300 Metro Blvd Ste 400, Edina, MN 55439-2307 | 2020-02-25 |
| 1831722594 | Collaboration for Psychological Wellness, LLC | Psychologist | 12000 Portland Ave Ste 120, Burnsville, MN 55337-4469 | 2020-02-20 |
| 1780214601 | Jennifer Jacqueline Felinski Kurtz | Psychologist | 16688 Kentucky Ave, Lakeville, MN 55044-4616 | 2020-01-20 |
| Find all providers with the same taxonomy | ||||
| City | COTTAGE GROVE |
| Zip Code | 55016 |
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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.