JACKLYN A KNOLL (NPI# 1699087411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699087411 |
| Entity Type | Individual |
| Full Name | JACKLYN A KNOLL |
| Other Name | JACKLYN A LEICK |
| Credential | PA-C |
| Practice Address |
500 Wind Ridge Dr Wausau WI 54401-4173 |
| Mailing Address |
500 Wind Ridge Dr. Wausau WI 54401-4173 |
| Practice Telephone | 7158472611 |
| Mailing Telephone | 7158472611 |
| Mailing Fax Number | 7158472612 |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2011-01-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2622-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
500 WIND RIDGE DR |
| City | WAUSAU |
| State | WI |
| Zip Code | 54401-4173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386644409 | Timothy P Grady | Internal Medicine | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2005-07-29 |
| 1942852504 | Patrick Henry Drechsler | Physician Assistant | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2019-07-14 |
| 1306407010 | Abbey Crossman | Physician Assistant | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2019-06-24 |
| 1144755232 | Kali Kann | Physician Assistant | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2017-04-26 |
| 1437699717 | Meghan Walls | Registered Nurse | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2017-03-06 |
| 1477905909 | Aaron Follensbee | Physician Assistant | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2016-07-08 |
| 1548688419 | Aspirus Wausau Hospital, Inc. | Internal Medicine | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2014-03-28 |
| 1336497197 | Jennifer Therese Krall | Nurse Practitioner | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2012-08-27 |
| 1336424316 | Deborah Sauer | Nurse Practitioner | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2011-10-20 |
| 1033411822 | Aspirus Clinics Inc. | Clinic/Center | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2010-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1336701895 | Amy Kluetz | Counselor | 3000 Westhill Drive, Suite 100, Wausau, WI 54401 | 2019-07-05 |
| 1437640877 | Joseph T Fitz | Student in an Organized Health Care Education/Training Program | Aspirus Wausau Family Medicine, 425 Wind Ridge Drive, Wausau, WI 54401 | 2018-05-22 |
| 1699293241 | Amanda Nedd | Dietitian, Registered | 425 Pine Ridge Boulevard Suite 220 C, Wausau, WI 54401 | 2017-09-05 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1013389618 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 2727 Plaza Dr., Wausau, WI 54401 | 2015-10-22 |
| 1881091163 | Judy Lao | Dental Hygienist | 413 North 17th Avenue, Wausau, WI 54401 | 2014-12-02 |
| 1295012011 | Allison Waraksa | Pharmacist | 504 S. 17th Ave, Wausau, WI 54401 | 2011-11-08 |
| 1881974053 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 504 S 17th Ave, Wausau, WI 54401 | 2011-08-19 |
| Find all providers in zip 54401 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487083242 | Andrew John Miller | Physician Assistant | 1521 Lakeview Ave, Wausau, WI 54401-6168 | 2013-11-02 |
| 1942852504 | Patrick Henry Drechsler | Physician Assistant | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2019-07-14 |
| 1306407010 | Abbey Crossman | Physician Assistant | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2019-06-24 |
| 1477905909 | Aaron Follensbee | Physician Assistant | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2016-07-08 |
| 1952742397 | Jessica Gaffaney | Physician Assistant | 333 Pine Ridge Blvd, Emergency Dept, Wausau, WI 54401-4120 | 2013-07-15 |
| 1649574898 | Daniel Thomas Line | Physician Assistant | 333 Pine Ridge Blvd, Wausau, WI 54401-4120 | 2011-01-03 |
| 1124352604 | Mollie J Berg | Physician Assistant | 2720 Plaza Dr, Suite 1100, Wausau, WI 54401-4158 | 2009-09-30 |
| 1942225339 | Sarah E Jaeger | Physician Assistant | 1810 N 2nd St, Wausau, WI 54401 | 2006-07-13 |
| 1851316871 | Brenda K Balthazor | Physician Assistant | 512 S 28th Ave, Wausau, WI 54401-4147 | 2006-07-12 |
| 1700817970 | Gina L Mcdowell | Physician Assistant | 515 S 32nd Ave, Wausau, WI 54401-4074 | 2006-07-06 |
| Find all providers in WAUSAU | ||||
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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.