MICHAEL RUSSELL NEUTKENS


Address: 480 Osborne Rd Ne, Fridley, MN 55432-2773
Phone: 7637854500

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant MN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 480 OSBORNE RD NE
City FRIDLEY
State MN
Zip Code 55432-2773

Providers in the same location

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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Providers in the same zip code

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 Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City FRIDLEY
Zip Code 55432

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Dataset Information

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.

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