ANNETTE W KUCK (NPI# 1902875826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902875826 |
| Entity Type | Individual |
| Full Name | ANNETTE W KUCK |
| Credential | NP |
| Practice Address |
6025 Lake Rd Ste110 Woodbury MN 55125-1709 |
| Practice Telephone | 6517357414 |
| Practice Fax Number | 6517351827 |
| Mailing Telephone | 6517357414 |
| Mailing Fax Number | 6517351827 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2011-11-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
R089470-8 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34860000 | 05 | |
| MN | 831022000 | 05 | |
| MN | HEALTHPARTNERS | HP23673 | 01 |
| MN | UCARE MN | 132742 | 01 |
| MN | AMERICA'S PPO | 1008767 | 01 |
| MN | MEDICA | 0407370 | 01 |
| Street Address |
6025 LAKE RD STE110 |
| City | WOODBURY |
| State | MN |
| Zip Code | 55125-1709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366439523 | Aaron Jeremy Milbank | Urology | 6025 Lake Rd, Suite 200, Woodbury, MN 55125-1712 | 2005-10-03 |
| 1891015384 | Mikhail Regelman | Urology | 6025 Lake Rd, Suite 200, Woodbury, MN 55125-1712 | 2010-06-07 |
| 1922233287 | Jodi Sharon Michaels | Urology | 6025 Lake Rd, Suite 200, Woodbury, MN 55125-1712 | 2009-05-15 |
| 1003058546 | Samuel Branch Kieley | Urology | 6025 Lake Rd, Suite 200, Woodbury, MN 55125-1712 | 2009-03-30 |
| 1649447368 | Michael Joseph Ehlert | Urology | 6025 Lake Rd, Suite 200, Woodbury, MN 55125-1712 | 2008-05-12 |
| 1629241062 | Anthony John Polcari | Urology | 6025 Lake Rd, Suite 200, Woodbury, MN 55125-1712 | 2008-04-07 |
| 1831367168 | Metropolitan Urologic Specialists Pa | Urology | 6025 Lake Rd, Suite 100, Woodbury, MN 55125 | 2008-02-20 |
| 1356549638 | David Nathan Prall | Urology | 6025 Lake Rd, Suite 200, Woodbury, MN 55125-1712 | 2007-07-06 |
| 1336355049 | Basir U Tareen | Urology | 6025 Lake Rd, Suite 200, Woodbury, MN 55125-1712 | 2007-05-16 |
| 1336352681 | Anna M Leininger | Genetic Counselor, MS | 6025 Lake Rd, Woodbury, MN 55125-1712 | 2007-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
| 1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
| 1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
| 1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
| 1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
| 1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
| 1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
| Find all providers in zip 55125 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699079608 | Lynette Guyer | Nurse Practitioner | 172 Main St., Woodbury, PA 16695-0075 | 2011-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619587193 | Sadiya Abdirahman Esse | Nurse Practitioner | 1690 Silver Lake Rd Nw, New Brighton, MN 55112-1788 | 2020-08-09 |
| 1881226512 | Abby Marie Zenner | Nurse Practitioner | 1771 Countryside Dr, Shakopee, MN 55379-4451 | 2020-02-11 |
| 1174019038 | Adedayo Temitope Dosumu | Nurse Practitioner | 816 50th Ave Nw, Rochester, MN 55901-6554 | 2018-07-03 |
| 1407223159 | Carla Sue Christenson | Nurse Practitioner | 3400 W. 66th St, Edina, MN 55435 | 2015-08-28 |
| 1538573449 | Rebecca Anne Lenz | Nurse Practitioner | 1172 Randolph Ave Apt 8, Saint Paul, MN 55105-2987 | 2014-06-18 |
| 1083027536 | Mueni C Mualuko | Nurse Practitioner | 2220 Riverside Ave # Ms 26602g, Geriatrics Department Ms 26602g/ 2220 Riverside Ave, Minneapolis, MN 55454-1321 | 2014-06-03 |
| 1659623999 | Joy Laansma | Nurse Practitioner | 3366 Oakdale Avenue North, Suite 551, Robbinsdale, MN 55422-2948 | 2012-10-10 |
| 1720337694 | Zhonghua Xie | Nurse Practitioner | 1202 5th Grant Blvd W, Wabasha, MN 55981-1115 | 2012-09-06 |
| 1487937892 | Jonathan Deforest Olson | Nurse Practitioner | 30 W 22nd St, #204, Minneapolis, MN 55404-2428 | 2011-09-21 |
| 1548577224 | Lorene Ann Gray | Nurse Practitioner | 6465 W Shadow Lake Dr, Lino Lakes, MN 55014-1982 | 2010-09-02 |
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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.