CANDACE E COONROD (NPI# 1649235102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649235102 |
| Entity Type | Individual |
| Full Name | CANDACE E COONROD |
| Credential | CNNP |
| Practice Address |
927 Churchill St W Stillwater MN 55082 |
| Mailing Address |
8170 33rd Ave S Mail Stop 21110q Bloomington MN 55425-4516 |
| Practice Telephone | 6514395330 |
| Practice Fax Number | 6514308591 |
| Mailing Telephone | 6514395330 |
| Mailing Fax Number | 6514308591 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2018-06-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
R0812036 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LN0005X |
Nurse Practitioner Specialization: Neonatal, Critical Care |
R0812036 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 224823900 | 05 |
| Street Address |
927 CHURCHILL ST W |
| City | STILLWATER |
| State | MN |
| Zip Code | 55082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942209911 | Patrick John Brod | Family Medicine | 927 Churchill St W, Stillwater, MN 55082-6605 | 2005-07-20 |
| 1487159836 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 927 Churchill St W, Stillwater, MN 55082-6605 | 2018-03-28 |
| 1659725398 | Kelsey Rae Morinville | Nurse Anesthetist, Certified Registered | 927 Churchill St W, Stillwater, MN 55082 | 2016-04-19 |
| 1760861108 | Gregory Schad | Pharmacist | 927 Churchill St W, Stillwater, MN 55082-6605 | 2015-05-19 |
| 1598084956 | Jennifer Lynn Boklewski | Emergency Medicine | 927 Churchill St W, Stillwater, MN 55082-6605 | 2010-05-25 |
| 1003132440 | Anika Schulte Phillips | Registered Nurse | 927 Churchill St W, Stillwater, MN 55082-6605 | 2010-04-09 |
| 1306076260 | Alison Wing | Internal Medicine | 927 Churchill St W, Stillwater, MN 55082-6605 | 2009-07-24 |
| 1285862045 | Casey Woster | Emergency Medicine | 927 Churchill St W, Stillwater, MN 55082-6605 | 2009-06-30 |
| 1689812604 | Kathleen M Dorwart | Pharmacist | 927 Churchill St W, Stillwater, MN 55082-6605 | 2009-01-29 |
| 1265670319 | Laura M Eryou | Pharmacist | 927 Churchill St W, Stillwater, MN 55082-6605 | 2009-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
| 1982238085 | Jerald Haley | Technician | 924 6th Ave. S., Stillwater, MN 55082 | 2020-02-27 |
| 1801457387 | Sun Trad Chin Acu Mn LLC | Acupuncturist | Compass Center for Healing, 116 Chestnut St. E., Stillwater, MN 55082 | 2019-06-25 |
| 1598243990 | Carlson Distinctive Dentistry, Pllc | Dentist | 1701 Curve Crest Blvd W Ste 100, Stillwater, MN 55082 | 2018-07-30 |
| 1073001624 | Lindsay Beth Briggs | Chiropractor | 200 Chestnut St E, Ste 202, Stillwater, MN 55082 | 2018-04-30 |
| 1578932943 | Group Health Plan, Inc | Family Medicine | 921 Greeley Street, Stillwater, MN 55082 | 2015-09-16 |
| 1184001919 | Grant Rohrig | Specialist/Technologist | 8727 Jeffrey Ave North, Stillwater, MN 55082 | 2015-04-30 |
| 1346688991 | Kellie Ann Seth | Chiropractor | 200 Chestnut St E Ste 202, Stillwater, MN 55082 | 2013-06-05 |
| 1770928426 | Rivertown Animal Hospital | Veterinarian | 135 New England Place, Stillwater, MN 55082 | 2013-05-08 |
| 1285929265 | Healtheast Medical Research Institute | Dietitian, Registered | 2900 Curve Crest Blvd, Stillwater, MN 55082 | 2011-06-17 |
| Find all providers in zip 55082 | ||||
| Taxonomy Code | 363LN0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568412922 | Sharron Thomson | Nurse Practitioner | Lakeview Hospital, 927 Churchill Street West, Stillwater, MN 55082 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346434461 | Debra L Lesslie | Nurse Practitioner | 347 North Smith Avenue, 70-505, Children's Specialty Clinic Nicu, St. Paul, MN 55102 | 2007-08-31 |
| 1679541056 | Deborah J Barth | Nurse Practitioner | 3668 Pinecrest Ct, Eagan, MN 55123-1000 | 2006-03-10 |
| 1720056518 | Nicole E Riley | Nurse Practitioner | 14223 Arbre Ln N, Hugo, MN 55038-4449 | 2006-03-09 |
| 1003891144 | Tracy Suzanne Cousin | Nurse Practitioner | 1200 6th Avenue N, St Cloud, MN 56303 | 2005-12-13 |
| 1528678133 | Kathy Daniella Lopez Vasquez | Nurse Practitioner | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-08-07 |
| 1558970376 | Corin Mauldin | Nurse Practitioner | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-07-28 |
| 1912525197 | Devon Ratliff-crain | Nurse Practitioner | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-07-14 |
| 1891313862 | Kelli Dawn Guth | Nurse Practitioner | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-07-07 |
| 1225663768 | Amanda Elizabeth Olsen | Nurse Practitioner | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-03-05 |
| 1538713201 | Erin Michelle Miller | Nurse Practitioner | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2019-07-30 |
| Find all providers with the same taxonomy | ||||
| City | STILLWATER |
| Zip Code | 55082 |
Please comment or provide details below to improve the information on CANDACE E COONROD.
| 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.