MR. JEROME TODD REZAC (NPI# 1851600092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851600092 |
| Entity Type | Individual |
| Full Name | MR. JEROME TODD REZAC |
| Credential | LPN |
| Practice Address |
216 E Main St Suite 1 Albert Lea MN 56007-2919 |
| Practice Telephone | 5073734300 |
| Practice Fax Number | 5073734304 |
| Mailing Telephone | 5073734300 |
| Mailing Fax Number | 5073734304 |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2010-10-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | L 65492-2 | MN | Nursing Service Providers |
| Street Address |
216 E MAIN ST SUITE 1 |
| City | ALBERT LEA |
| State | MN |
| Zip Code | 56007-2919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922001973 | Teresa Mary Anderson-krull | Social Worker | 216 E Main St, Albert Lea, MN 56007-2919 | 2005-05-23 |
| 1205145471 | Southern Minnesota Care, LLC | Home Health | 216 E Main St, Suite #1, Albert Lea, MN 56007-2919 | 2010-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700395860 | Kelsey Paulson | Massage Therapist | 1629 West Main Street, Touchworks Massage Skyline Plaza, Albert Lea, MN 56007 | 2017-09-21 |
| 1366984536 | Allied Health Care Professional Service Corporation | Health Maintenance Organization | 140 W Clark St, Albert Lea, MN 56007 | 2016-11-05 |
| 1174875165 | Michael Gene White | Pharmacist | 1615 West Main St, Albert Lea, MN 56007 | 2012-10-15 |
| 1841596384 | Elizabeth Jordan Berg | Chiropractor | 72599 220th St, Albert Lea, MN 56007 | 2011-02-01 |
| 1235453606 | Michael Aaron Starner | Physician Assistant | 404 W Fountain St Unit 516, Albert Lea, MN 56007 | 2010-03-15 |
| 1215149364 | John M Enger, Professional Association | Podiatrist | 904 E Plaza Street, Albert Lea, MN 56007 | 2007-05-03 |
| 1760532485 | Lowell Wherry Barr | Pediatrics | 203 W Clark, Albert Lea, MN 56007 | 2007-01-12 |
| 1073688917 | Wendy Elizabeth Walker | Psychologist | 117 South Newton Avenue, Albert Lea, MN 56007 | 2006-11-22 |
| 1487739090 | Rem Woodvale Inc | Intermediate Care Facility, Mentally Retarded | 1204 Plainview Lane, Albert Lea, MN 56007 | 2006-10-25 |
| 1275621294 | Eleanor Wanden | Technician | 1815 Minnesota Ave, Albert Lea, MN 56007 | 2006-10-11 |
| Find all providers in zip 56007 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437774437 | Mackensie Eder | Licensed Practical Nurse | 12310 Singletree Ln Apt 2334, Eden Prairie, MN 55344-7983 | 2020-06-15 |
| 1659990331 | Sybilla Materla | Licensed Practical Nurse | 20694 Keystone Ave Unit C, Lakeville, MN 55044-6175 | 2020-04-13 |
| 1760021067 | S&e Staffing | Licensed Practical Nurse | 14250 43rd Ave N Apt D, Plymouth, MN 55446-3628 | 2020-01-03 |
| 1548815590 | Ritajo Ellenberger | Licensed Practical Nurse | 220 Oak Street North, Alexandria, MN 56308 | 2019-08-06 |
| 1699327858 | Agnes Remeshi | Licensed Practical Nurse | 2070 9th Ave E Apt 105, North Saint Paul, MN 55109-2242 | 2019-07-09 |
| 1780143453 | Shari Bernice Duwenhoegger | Licensed Practical Nurse | 9037 Garland Ln N, Maple Grove, MN 55311-1285 | 2019-03-13 |
| 1194281998 | Sawo M Lansana | Licensed Practical Nurse | 14125 Virginia Ave S Ste 311, Savage, MN 55378-2669 | 2019-02-16 |
| 1811453061 | Lacey Evelius | Licensed Practical Nurse | 400 Mineral Pond Ct, Anoka, MN 55303-1049 | 2019-02-13 |
| 1467923243 | Chinenye Amadi | Licensed Practical Nurse | 1350 High Site Dr Apt 218, Eagan, MN 55121-2153 | 2018-12-05 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| Find all providers with the same taxonomy | ||||
| City | ALBERT LEA |
| Zip Code | 56007 |
Please comment or provide details below to improve the information on MR. JEROME TODD REZAC.
| 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.