MICHAEL RUSSELL NEUTKENS (NPI# 1750722617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750722617 |
Entity Type | Individual |
Full Name | MICHAEL RUSSELL NEUTKENS |
Credential | P.A.-C. |
Practice Address |
480 Osborne Rd Ne Fridley MN 55432-2773 |
Practice Telephone | 7637854500 |
Enumeration Date | 2013-07-08 |
Last Update Date | 2017-10-04 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | MN | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
480 OSBORNE RD NE |
City | FRIDLEY |
State | MN |
Zip Code | 55432-2773 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275528671 | Multicare Associates of The Twin Cities,pa | Obstetrics & Gynecology | 480 Osborne Rd Ne, Suite 100, Fridley, MN 55432-2773 | 2005-09-13 |
1063923233 | Christina Louise Ann Her | Occupational Therapist | 480 Osborne Rd Ne, Fridley, MN 55432-2773 | 2017-10-16 |
1972039527 | North Memorial Health Care | Clinic/Center | 480 Osborne Rd Ne, #100, Fridley, MN 55432-2773 | 2017-05-02 |
1619401270 | Betlehem Semahge | Family Medicine | 480 Osborne Rd Ne, Fridley, MN 55432-2773 | 2017-04-20 |
1588035612 | Yelena Babashova | Physician Assistant | 480 Osborne Rd Ne, Fridley, MN 55432-2773 | 2015-10-15 |
1285014811 | Nura Pa | Durable Medical Equipment & Medical Supplies | 480 Osborne Rd Ne, Suite 260, Fridley, MN 55432-2773 | 2015-06-09 |
1194105841 | Pain Centers of Minnesota - Fridley, LLC | Clinic/Center | 480 Osborne Rd Ne, Suite 260, Fridley, MN 55432-2773 | 2015-06-08 |
1003215542 | Alison Gardner | Physician Assistant | 480 Osborne Rd Ne, Fridley, MN 55432-2773 | 2014-08-20 |
1629408687 | Danielle Elizabeth Nelson | Physician Assistant | 480 Osborne Rd Ne, Fridley, MN 55432-2773 | 2013-11-12 |
1043646029 | Patrick David Carlson | Physical Therapist | 480 Osborne Rd Ne, #280, Fridley, MN 55432-2773 | 2013-09-23 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
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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 |
---|---|---|---|---|
1760435036 | Colleen L Weed | Physician Assistant | 550 Osborne Rd, Ne, Fridley, MN 55432 | 2006-05-18 |
1588638514 | Amy C Lindell | Physician Assistant | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2006-02-15 |
1497757470 | Marguerite Nancy Kibira | Physician Assistant | 755 53rd Ave Ne, Fridley, MN 55421-1240 | 2005-08-10 |
1568999126 | Peter D Fitzgerald | Physician Assistant | 8290 University Ave Ne, Fridley, MN 55432-1847 | 2017-05-15 |
1912358219 | Kelli Michelle Cannata | Physician Assistant | 8290 University Ave Ne, Ste 200, Fridley, MN 55432-1847 | 2016-06-28 |
1588035612 | Yelena Babashova | Physician Assistant | 480 Osborne Rd Ne, Fridley, MN 55432-2773 | 2015-10-15 |
1891101838 | Katie Mclaughlin | Physician Assistant | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2014-07-10 |
1760897979 | Jennifer Beck | Physician Assistant | 550 Osborne Rd Ne, Fridley, MN 55432-2718 | 2014-06-25 |
1205277571 | Nea Rae Bennington | Physician Assistant | 8290 University Ave Ne, Suite 200, Fridley, MN 55432-1847 | 2013-07-15 |
1356789952 | Rachael Moberg | Physician Assistant | 755 53rd Ave Ne, Cvs Minute Clinic, Fridley, MN 55421-1240 | 2013-06-05 |
Find all providers in FRIDLEY |
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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.