HEATHER RUTH EDGREN (NPI# 1790394914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790394914 |
| Entity Type | Individual |
| Full Name | HEATHER RUTH EDGREN |
| Practice Address |
13784 W Airigin Dr Big Lake AK 99652 |
| Mailing Address |
Po Box 521611 Big Lake AK 99652-1611 |
| Practice Telephone | 9073151517 |
| Mailing Telephone | 9073151517 |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-07-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers |
| Street Address |
13784 W AIRIGIN DR |
| City | BIG LAKE |
| State | AK |
| Zip Code | 99652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740745439 | Susan Olson Dmd Inc | Clinic/Center | 3261 S. Big Lake Rd. Ste D3-d4, Big Lake, AK 99652 | 2019-02-06 |
| 1306293428 | Renae Jean Nelson | Massage Therapist | 3498 South Lakeview Loop, Big Lake, AK 99652 | 2016-05-18 |
| 1568828614 | Lakeview Massage Therapy | Massage Therapist | 3498 S Lakeview Loop, Big Lake, AK 99652 | 2016-01-05 |
| 1679995435 | Julie Dittman | Registered Nurse | 14988 W. Fireweed Dr., Big Lake, AK 99652 | 2014-01-14 |
| 1891034575 | Kidability Physical Therapy, LLC | Physical Therapist | 6406 S. Gonder Road, Big Lake, AK 99652 | 2013-01-31 |
| 1912250804 | Valley Mover | Bus | 8336 W Parks Highway, Meadow Lakes, AK 99652 | 2012-10-17 |
| 1013047117 | Arctic Chiropractic West Mat-su, LLC | Chiropractor | Mile 51 George Parks Hwy, #2, Big Lake, AK 99652 | 2007-03-07 |
| 1861637555 | Rainbow Medical Clinic | Physician Assistant | 10927 West Parks Hwy., Big Lake, AK 99652-0562 | 2008-12-09 |
| 1467824359 | Margaret Maixner | Nurse Practitioner | 7593 Larry's Lane, Big Lake, AK 99652-1792 | 2015-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962011635 | Chad Talbot | Counselor | 19591 Station St Apt 308, Big Lake, MN 55309-9436 | 2020-07-28 |
| 1366051203 | Chrystle Williefay White | Massage Therapist | 12900 W Creek Frontage Rd, Big Lake, AK 99623-4880 | 2020-07-27 |
| 1073121166 | Kira Jeannette Powell | Dentist | 20460 County Road 11 Nw, Big Lake, MN 55309-4851 | 2020-07-15 |
| 1295353621 | Moriah Gabrielle Krueger | Counselor | 19900 214th Ave Nw, Big Lake, MN 55309-8977 | 2020-07-13 |
| 1356986475 | Barbro E Strom Langley | Technician | 16901 River View Cir, Big Lake, MN 55309 | 2019-11-13 |
| 1457901506 | Centracare Health System | Emergency Medicine | 121 Lake St N, Big Lake, MN 55309-9254 | 2019-09-19 |
| 1457821795 | Grant Michael Vickerman | Specialist/Technologist | 22037 181st St Nw, Big Lake, MN 55309-8243 | 2018-11-29 |
| 1053813956 | Donna Gotzian | Registered Nurse | 18874 243rd Ave Nw, Big Lake, MN 55309-8208 | 2018-03-06 |
| 1932614518 | Melissa Ann Poehler | Counselor | 410 Martin Ave, Big Lake, MN 55309-8004 | 2017-12-05 |
| 1952815359 | Carrie Crockford | Marriage & Family Therapist | 25526 189th St Nw, Big Lake, MN 55309-4509 | 2017-11-21 |
| Find all providers in BIG LAKE | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356986475 | Barbro E Strom Langley | Technician | 16901 River View Cir, Big Lake, MN 55309 | 2019-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404785 | Lauren J Hulse | Technician | 3310 Nowell Ave, Juneau, AK 99801-1936 | 2020-07-16 |
| 1104467539 | Hilary Lashawn Patterson | Technician | 207 Muldoon Rd, Anchorage, AK 99504-1516 | 2019-10-07 |
| 1871143198 | Peggy R Giles | Technician | 4442 E 5th Ave, Anchorage, AK 99508-2223 | 2019-09-18 |
| 1679122543 | Pamela Sue Hill | Technician | 11723 Birch Knoll Loop, Anchorage, AK 99515-4310 | 2019-09-04 |
| 1255804423 | Ann Lind | Technician | 4299 Marion Dr, Juneau, AK 99801-9253 | 2019-01-09 |
| 1811399769 | Tala Vaifanua | Technician | 426 N Bragaw St, Anchorage, AK 99508-1315 | 2014-09-23 |
| 1336576727 | Leland Hebert | Technician | 420 Ocean Point Dr, Anchorage, AK 99515-4424 | 2013-10-01 |
| 1982048658 | Isaia Luafulu | Technician | 7233 Madelynne Dr, Anchorage, AK 99504-4656 | 2013-04-24 |
| 1932442498 | Christopher Paul Jackson | Technician | 7821 Island Dr, Anchorage, AK 99504-2728 | 2013-04-03 |
| 1447591227 | Julieelaine Pentecostes | Technician | 6700 Howard Ave, Anchorage, AK 99504-1895 | 2013-03-04 |
| 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.