LUKE A. HERDINA (NPI# 1720118912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720118912 |
| Entity Type | Individual |
| Full Name | LUKE A. HERDINA |
| Credential | P.A.-C |
| Practice Address |
16830 198th Ave Nw Big Lake Clinic Big Lake MN 55309 |
| Mailing Address |
P.o. Box 539 16830 198th Ave Nw Big Lake Clinic Big Lake MN 55309 |
| Practice Telephone | 7632637300 |
| Mailing Telephone | 7632637300 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2009-05-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1259 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
0630 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
16830 198TH AVE NW BIG LAKE CLINIC |
| City | BIG LAKE |
| State | MN |
| Zip Code | 55309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801873674 | Glenn W Weidenbacher | Pediatrics | 16830 198th Ave Nw, Big Lake Clinic, Big Lake, MN 55309 | 2005-12-22 |
| 1003226416 | Sarah E Johnson | Dietitian, Registered | 16830 198th Ave Nw, Centracare Clinic - Big Lake, Big Lake, MN 55309-4860 | 2014-05-07 |
| 1942438270 | Jessica L Hodson | Family Medicine | 16830 198th Ave Nw, Centracare Clinic Big Lake, Big Lake, MN 55309-4860 | 2009-06-25 |
| 1043479876 | Nabeel Bishara Ailabouni | Family Medicine | 16830 198th Ave Nw, Big Lake Clinic, Big Lake, MN 55309 | 2008-06-06 |
| 1013104348 | Centracare Clinic | Durable Medical Equipment & Medical Supplies | 16830 198th Ave Nw, Centracare Clinic - Big Lake, Big Lake, MN 55309-4860 | 2007-10-01 |
| 1801845391 | St. Cloud Hospital | Clinic/Center | 16830 198th Ave Nw, Big Lake Clinic, Big Lake, MN 55309 | 2006-05-10 |
| 1417924994 | Lola B Sutherland | Family Medicine | 16830 198th Ave Nw, Big Lake Clinic, Big Lake, MN 55309 | 2006-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356986475 | Barbro E Strom Langley | Technician | 16901 River View Cir, Big Lake, MN 55309 | 2019-11-13 |
| 1629589544 | Pdg, Pa | Clinic/Center | 16991 198th Ave Nw, Big Lake, MN 55309 | 2017-10-18 |
| 1669821765 | Laura Ann Dill | Dentist | 290 Eagle Lake Rd N, Big Lake, MN 55309 | 2016-06-09 |
| 1295008068 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 171 Henry Road, Big Lake, MN 55309 | 2012-02-09 |
| 1013280882 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 177 Henry Road, Big Lake, MN 55309 | 2012-02-09 |
| 1760704712 | Mary Ellen Venzke | Adult Companion | 19729 183rd Avenue, Big Lake, MN 55309 | 2010-02-18 |
| 1174700611 | Country Services Inc | Case Management | 641 Park Ave E, Big Lake, MN 55309 | 2008-01-28 |
| 1942481593 | Monticello Dental Group | Dentist | 20460 Co. Rd.11 Nw, Big Lake, MN 55309 | 2007-11-23 |
| 1336367242 | Family Prospective Resources, Inc | Marriage & Family Therapist | 35 Lake St So, Big Lake, MN 55309 | 2007-04-23 |
| 1598983470 | Jennifer Ann Lawrence | Marriage & Family Therapist | 35 Lake Street South #200, Big Lake, MN 55309 | 2007-04-23 |
| Find all providers in zip 55309 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969150 | Isaac Waalen | Physician Assistant | 5420 Circle Down, Minneapolis, MN 55416-1312 | 2020-03-28 |
| 1730643701 | Christina Jones | Physician Assistant | 11850 Blackfoot St Nw Ste 270, Coon Rapids, MN 55433-2593 | 2019-01-24 |
| 1114492964 | Molly Goss | Physician Assistant | 1817 Sunset Dr, Northfield, MN 55057-3246 | 2018-10-09 |
| 1932600160 | Ellen Kathryn Freeman | Physician Assistant | 111 Hundertmark Rd Ste 480, Chaska, MN 55318-1485 | 2018-02-22 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1073051751 | Hannah Elizabeth Rosenthal Danielson | Physician Assistant | 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 | 2017-02-02 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1538545686 | Kathryn Jelle | Physician Assistant | 3931 Louisiana Ave S # 55426, St Louis Park, MN 55426-5000 | 2015-07-30 |
| 1831503267 | Karrah Oliver | Physician Assistant | 205 Roosevelt Ave W, Karlstad, MN 56732-4022 | 2014-06-13 |
| 1477981777 | Melissa Ferraz De Toledo | Physician Assistant | 9145 Springbrook Dr Nw Ste 300, Coon Rapids, MN 55433-5897 | 2013-10-23 |
| Find all providers with the same taxonomy | ||||
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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.