JENELLE CECILIA ROCK (NPI# 1790922755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790922755 |
Entity Type | Individual |
Full Name | JENELLE CECILIA ROCK |
Other Name | JENELLE CECILIA GREEN |
Credential | PA-C |
Practice Address |
1950 Northwestern Ave S Suite 102 Stillwater MN 55082-7590 |
Mailing Address |
1950 Northwestern Ave S Ste 102 Stillwater MN 55082-7615 |
Practice Telephone | 6514303800 |
Practice Fax Number | 6514303827 |
Mailing Telephone | 6514303800 |
Mailing Fax Number | 6514303827 |
Enumeration Date | 2009-01-13 |
Last Update Date | 2016-02-03 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NE | 47061995513 | 05 |
Street Address |
1950 NORTHWESTERN AVE S SUITE 102 |
City | STILLWATER |
State | MN |
Zip Code | 55082-7590 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
1982238085 | Jerald Haley | Technician | 924 6th Ave. S., Stillwater, MN 55082 | 2020-02-27 |
1801457387 | Sun Trad Chin Acu Mn LLC | Acupuncturist | Compass Center for Healing, 116 Chestnut St. E., Stillwater, MN 55082 | 2019-06-25 |
1598243990 | Carlson Distinctive Dentistry, Pllc | Dentist | 1701 Curve Crest Blvd W Ste 100, Stillwater, MN 55082 | 2018-07-30 |
1073001624 | Lindsay Beth Briggs | Chiropractor | 200 Chestnut St E, Ste 202, Stillwater, MN 55082 | 2018-04-30 |
1578932943 | Group Health Plan, Inc | Family Medicine | 921 Greeley Street, Stillwater, MN 55082 | 2015-09-16 |
1184001919 | Grant Rohrig | Specialist/Technologist | 8727 Jeffrey Ave North, Stillwater, MN 55082 | 2015-04-30 |
1346688991 | Kellie Ann Seth | Chiropractor | 200 Chestnut St E Ste 202, Stillwater, MN 55082 | 2013-06-05 |
1770928426 | Rivertown Animal Hospital | Veterinarian | 135 New England Place, Stillwater, MN 55082 | 2013-05-08 |
1285929265 | Healtheast Medical Research Institute | Dietitian, Registered | 2900 Curve Crest Blvd, Stillwater, MN 55082 | 2011-06-17 |
Find all providers in zip 55082 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578581682 | Lisa Marie Fritz | Physician Assistant | 1950 Curve Crest Blvd W, Suite 100, Stillwater, MN 55082-5078 | 2006-07-17 |
1063442085 | Cynthia G. Goetz | Physician Assistant | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2006-07-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194120204 | Nathan C Clapper | Physician Assistant | 3580 Arcade St Ste 100, Vadnais Heights, MN 55127-7135 | 2014-10-31 |
1003180555 | Elizabeth K Saterenzoller | Physician Assistant | 1015 Marsh Street, Mankato, MN 56002-8673 | 2012-03-01 |
1477824472 | Andrea Jo Pitzl | Physician Assistant | 3208 36th Ave Ne, St Anthony, MN 55418-1713 | 2012-01-23 |
1447560693 | Jeanine Marie Edstrom | Physician Assistant | 1185 Town Centre Dr Ste 200, Eagan, MN 55123-1343 | 2010-10-20 |
1841504792 | Michelle R Aumock | Physician Assistant | 8100 W 78th Street, Ste 230, Edina, MN 55439 | 2010-08-03 |
1194042390 | Gerald Frederick Anderson | Physician Assistant | 4060 Haines Rd, #104, Duluth, MN 55811-1746 | 2010-04-27 |
1558683904 | Oswaldo Serge | Physician Assistant | 4036 3rd St Nw, Rochester, MN 55901-7564 | 2010-02-25 |
1417288945 | Amanda Kay Johnson | Physician Assistant | 201 W Center St Ei-01 Surgical Assistant, Rochester, MN 55902-3003 | 2010-01-22 |
1174775514 | Nathan J Nistler | Physician Assistant | 3580 Arcade Stq, Vadnais Heights, MN 55127-7135 | 2008-10-16 |
1811164007 | Leah Anne Zupancich | Physician Assistant | 2545 Chicago Ave. S., Suite 106, Minneapolis, MN 55404 | 2008-05-15 |
Find all providers with the same taxonomy |
City | STILLWATER |
Zip Code | 55082 |
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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.