LAVONNE M CHARBONNEAU (NPI# 1700867397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700867397 |
| Entity Type | Individual |
| Full Name | LAVONNE M CHARBONNEAU |
| Credential | PA-C |
| Practice Address |
114 3rd St Ne Rolla ND 58367-7137 |
| Mailing Address |
Po Box 699 114 Ne 3rd St Rolla ND 58367-0699 |
| Practice Telephone | 7014773111 |
| Practice Fax Number | 7014776342 |
| Mailing Telephone | 7014773111 |
| Mailing Fax Number | 7014776342 |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2010-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PAC0002 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
114 3RD ST NE |
| City | ROLLA |
| State | ND |
| Zip Code | 58367-7137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508472473 | Christine Genevieve Hedstrom | Physician Assistant | 114 3rd St Ne, Rolla, ND 58367-7137 | 2020-09-16 |
| 1356847446 | Brayden Walker | Nurse Practitioner | 114 3rd St Ne, Rolla, ND 58367-7137 | 2018-04-05 |
| 1891213328 | Christy Zinck | Nurse Practitioner | 114 3rd St Ne, Rolla, ND 58367-7137 | 2017-09-05 |
| 1720334410 | Michael Thomas Mcqueeney | Physician Assistant | 114 3rd St Ne, Rolla, ND 58367-7137 | 2012-07-31 |
| 1225369523 | Northland Health Partners Community Health Center | Clinic/Center | 114 3rd St Ne, Rolla, ND 58367 | 2010-01-26 |
| 1366639213 | Lilia Marcelina Cid | Family Medicine | 114 3rd St Ne, Rolla, ND 58367-7137 | 2007-09-25 |
| 1215948435 | Rolla Clinic, P.C. | Family Medicine | 114 3rd St Ne, Rolla, ND 58367-7137 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053946343 | Kayla M Wallette | Technician, Other | 1102 Main Ave, Rolla, ND 58367 | 2020-03-06 |
| 1972092757 | William David Nix | Case Manager/Care Coordinator | 102 Main Ave W, Rolla, ND 58367 | 2018-05-07 |
| 1598138745 | Catherine Minick | Case Manager/Care Coordinator | 1102 Main Ave W, Rolla, ND 58367 | 2015-11-10 |
| 1881008266 | Rolette County Social Services | Case Management | 210 2nd Ave Ne, Rolla, ND 58367 | 2014-06-13 |
| 1346318268 | Commmunity Ambulance Service, Inc | Ambulance | 217 5th Ave Ne, Rolla, ND 58367 | 2006-11-30 |
| 1831735257 | Kyla Marie Larocque | Case Manager/Care Coordinator | 102 Main Ave W, Rolla, ND 58367 | 2019-11-20 |
| 1598204489 | Laura L Waagen | Social Worker | 1102 Main Ave W, Rolla, ND 58367 | 2017-02-13 |
| 1629224829 | Susan M. Davis | Counselor | 113 Main Ave E, Rolla, ND 58367 | 2008-08-07 |
| 1588848741 | Andrea E Laverdure | Counselor | 113 Main Ave E, Rolla, ND 58367 | 2007-12-24 |
| 1750565917 | Lisa Marie Neameyer | Social Worker | 113 Main Ave E, Rolla, ND 58367 | 2007-12-24 |
| Find all providers in zip 58367 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508472473 | Christine Genevieve Hedstrom | Physician Assistant | 114 3rd St Ne, Rolla, ND 58367-7137 | 2020-09-16 |
| 1205306156 | Marisa Ann Yates | Physician Assistant | 910 W 10th St, Rolla, MO 65409-6519 | 2018-12-03 |
| 1295268928 | Morton County Hospital | Physician Assistant | 415 Washington, Rolla, KS 67954-0098 | 2017-04-10 |
| 1780120980 | Morgan Lange | Physician Assistant | 213 2nd Ave Ne, Rolla, ND 58367-7153 | 2017-01-11 |
| 1497115497 | Di'ara Woods | Physician Assistant | 1605 Martin Springs Dr, Ste 230, Rolla, MO 65401-2982 | 2016-03-03 |
| 1487046181 | Pamela N. Gray | Physician Assistant | 1050 W 10th St, Rolla, MO 65401-2905 | 2015-03-04 |
| 1992120281 | Adam Glenn Feigenbaum | Physician Assistant | 1000 W 10th St, Rolla, MO 65401-2905 | 2014-02-24 |
| 1407195498 | Phelps Emergency Group LLC | Physician Assistant | 1000 W 10th St, Rolla, MO 65401-2905 | 2013-02-11 |
| 1376880237 | Nicole Lawson | Physician Assistant | 1000 W 10th St, Rolla, MO 65401-2905 | 2013-01-12 |
| 1053638577 | Jennifer Lynn Bremer | Physician Assistant | 600 Blues Lake Pkwy, Rolla, MO 65401-8022 | 2010-04-23 |
| Find all providers in ROLLA | ||||
Please comment or provide details below to improve the information on LAVONNE M CHARBONNEAU.
| 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.