JENELLE CECILIA ROCK


Address: 1950 Northwestern Ave S, Suite 102, Stillwater, MN 55082-7590
Phone: 6514303800

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NE 47061995513 05

Office Location

Street Address 1950 NORTHWESTERN AVE S
SUITE 102
City STILLWATER
State MN
Zip Code 55082-7590

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NPI Name Taxonomy Address Enumeration
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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
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City STILLWATER
Zip Code 55082

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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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