TIFFANY ALICIA AXTMAN (NPI# 1699397042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699397042 |
| Entity Type | Individual |
| Full Name | TIFFANY ALICIA AXTMAN |
| Practice Address |
1601 Golf Course Rd Grand Rapids MN 55744-8648 |
| Practice Telephone | 2183263401 |
| Mailing Telephone | 2183263401 |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-07-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 7254 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1601 GOLF COURSE RD |
| City | GRAND RAPIDS |
| State | MN |
| Zip Code | 55744-8648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326023060 | Jack Victor Carlisle | Family Medicine | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2005-12-14 |
| 1568076602 | Tyler Wesley Waller | Pharmacist | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2020-09-05 |
| 1710511282 | Kelly Manner | Dietitian, Registered | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2020-02-24 |
| 1285273292 | Patrick James Nelson | Physician Assistant | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-12-23 |
| 1801446943 | Natalie Jo Castle | Physician Assistant | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-09-19 |
| 1578121356 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-06-05 |
| 1487210233 | Jake Heggem | Pharmacist | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-05-17 |
| 1902379159 | Grand Itasca Clinic and Hospital | Pharmacy | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-01-09 |
| 1548768534 | Michelle Overbye | Nurse Practitioner | 1601 Golf Course Rd, Grand Rapids, MN 55744 | 2018-01-25 |
| 1922457969 | Angela Degrio | Obstetrics & Gynecology | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2016-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
| 1821631391 | Patrice Marie Curtiss | Technician | 23792 Winckler Road, Grand Rapids, MN 55744 | 2019-10-28 |
| 1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
| 1780081877 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 | 2014-12-04 |
| 1912311333 | Doctor V LLC | Psychologist | 2002 Cromell Drive, Hope House of Itasca County, Laprairie, MN 55744 | 2014-06-13 |
| 1104244987 | Linda Reinen-thompson | Contractor | 34307 Hwy. 38, Grand Rapids, MN 55744 | 2014-03-31 |
| 1275883266 | Lana Rae Jacobson | Registered Nurse | 1401 Nw 9th Street, Grand Rapids, MN 55744 | 2012-09-17 |
| 1518252048 | David Allen Griggs | Pharmacist | 2140 S.pokegama Ave., T-0904, Target, Grand Rapids, MN 55744 | 2011-06-13 |
| 1447575063 | Kelly Ann Shermoen | Pharmacist | 18 Se 10th Street, Grand Rapids, MN 55744 | 2010-04-07 |
| Find all providers in zip 55744 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295333938 | Amanda Covell | Nurse Practitioner | 624 Cherry St Se Apt 5, Grand Rapids, MI 49503-4778 | 2020-10-14 |
| 1699315747 | Kevin Hengeveld | Nurse Practitioner | 300 Lafayette Ave Se Ste 2045, Grand Rapids, MI 49503-4692 | 2020-01-07 |
| 1134765027 | Kerri L. Pighetti | Nurse Practitioner | 4829 E Beltline Ave Ne Ste 300, Grand Rapids, MI 49525-9350 | 2019-11-26 |
| 1497398374 | Brittany Pebbles | Nurse Practitioner | 2155 E Paris Ave Se Ste 220, Grand Rapids, MI 49546-6142 | 2019-10-23 |
| 1386205912 | Erica Lea Spalding | Nurse Practitioner | 310 Lafayette Ave Se Ste 400, Grand Rapids, MI 49503-4693 | 2019-06-25 |
| 1184024481 | Kari Jo Hill | Nurse Practitioner | 310 Lafayette Ave Se Ste 415, Grand Rapids, MI 49503-4693 | 2014-08-25 |
| 1861798878 | Julie A Grech | Nurse Practitioner | 221 Michigan Ne, Suite 600, Grand Rapids, MI 49503 | 2011-02-09 |
| 1104121714 | Karen Bliss Harper | Nurse Practitioner | 3230 Eagle Park Dr Ne Ste 200, Heartland Hospice #4624, Grand Rapids, MI 49525-7047 | 2011-01-13 |
| 1235459033 | Sandra Van Brouwer | Nurse Practitioner | 35 Michigan St. Ne, Suite 4150, Grand Rapids, MI 49503-2539 | 2010-06-03 |
| 1225269095 | Connie Ruth Mattice | Nurse Practitioner | 425 Cherry St. S.e, Planned Parenthood Centers of West Michigan, Grand Rapids, MI 49503 | 2009-07-28 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 55744 |
Please comment or provide details below to improve the information on TIFFANY ALICIA AXTMAN.
| 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.