ELLEN FASTNER (NPI# 1952719254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952719254 |
| Entity Type | Individual |
| Full Name | ELLEN FASTNER |
| Credential | NP |
| Practice Address |
11269 Jefferson Hwy N Champlin MN 55316 |
| Mailing Address |
2925 Chicago Ave Minneapolis MN 55407-1321 |
| Practice Telephone | 7632360600 |
| Mailing Telephone | 6122625000 |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2018-06-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 1284 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R126105-5 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11269 JEFFERSON HWY N |
| City | CHAMPLIN |
| State | MN |
| Zip Code | 55316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508849530 | Kaye Ann Marie Abel | Pediatrics | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2005-11-23 |
| 1801402722 | Allina Health System | Clinic/Center | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2020-09-16 |
| 1578175501 | Tonya Lynn Freeman | Psychologist | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2020-08-20 |
| 1386180875 | Erin Erickson | Registered Nurse | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2017-01-09 |
| 1780075630 | Katelyn Moritz | Nurse Practitioner | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2015-02-13 |
| 1215371471 | Chameng V Vang | Family Medicine | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2013-04-18 |
| 1780978023 | Mark Christopher Goetz | Psychologist | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2011-06-03 |
| 1871899674 | Allina Health System | Clinic/Center | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2011-01-27 |
| 1497989214 | Allison R Hotujec | Family Medicine | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2009-05-07 |
| 1740424928 | Lea Hilda Ekochin | Internal Medicine | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2009-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493903 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 11995 Business Park Blvd N, Champlin, MN 55316 | 2020-10-02 |
| 1598300675 | Dentalign, Pa | Dentist | 11942 Business Park Blvd, Champlin, MN 55316 | 2019-11-12 |
| 1811463573 | Vikings Home Health Care LLC | Meals | 11551 Georgia Ave, N, Champlin, MN 55316 | 2018-10-22 |
| 1255853305 | Matthew L Boelter | Hearing Instrument Specialist | 11451 Oregon Ave N, Champlin, MN 55316 | 2017-07-11 |
| 1194198309 | Champlin Dentistry, PC | Dentist | 11231 Aquila Drive N, Champlin, MN 55316 | 2015-11-10 |
| 1336557412 | Kelsey Voigt | Pharmacist | 11990 Business Park Blvd, Champlin, MN 55316 | 2014-08-01 |
| 1346502523 | Transitions Home Care Ltd | Home Health | 11030 Douglas Drive North, Champlin, MN 55316 | 2012-06-13 |
| 1639373285 | Michael D Smilanich | Dentist | 11231 Aquila Dr N, Champlin, MN 55316 | 2007-06-14 |
| 1760532907 | Kurt Allan Bender | Dentist | 500 A Jefferson Hwy, Champlin, MN 55316 | 2007-01-11 |
| 1366529752 | Gregory Allan Holmberg | Chiropractor | #8 3rd Street Nw, Osseo, MN 55316 | 2006-11-01 |
| Find all providers in zip 55316 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366060121 | Miranda Helmers | Nurse Practitioner | 9203 124th Pl N, Champlin, MN 55316-1934 | 2020-07-08 |
| 1629554449 | Amy Rasmussen | Nurse Practitioner | 11269 Jefferson Hwy N Fl 1, Champlin, MN 55316-3123 | 2018-07-15 |
| 1720042625 | Jan Elaine Youngblood | Nurse Practitioner | 11990 Business Park Blvd N, Champlin, MN 55316-2005 | 2006-04-17 |
| 1598722308 | Janet M Siciliano | Nurse Practitioner | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2006-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466368 | Amalia Jo Folland Harvey | Nurse Practitioner | 19883 Evensong Ct, Farmington, MN 55024-8688 | 2020-10-29 |
| 1710586235 | Jackelyn Laura Peterson | Nurse Practitioner | 10101 Bren Rd E Unit 345, Minnetonka, MN 55343-0060 | 2020-10-26 |
| 1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
| 1861091704 | Morgan Rohl | Nurse Practitioner | 117 12th Ave Nw Apt 2, Rochester, MN 55901-2787 | 2020-10-21 |
| 1063010304 | Kalie R Mccauley | Nurse Practitioner | 11452 Brook Rd Nw, Elk River, MN 55330-8739 | 2020-10-09 |
| 1659978930 | Sarah Jean Mudge | Nurse Practitioner | 350 Harbor Dr, Duluth, MN 55802-2600 | 2020-10-08 |
| 1285231621 | Karlu Dorleh | Nurse Practitioner | 14151 Territorial Rd Unit 212, Maple Grove, MN 55369-5725 | 2020-10-08 |
| 1447857669 | Kimberly Dawn Bursch-tewalt | Nurse Practitioner | 11884 237th Ave Nw, Elk River, MN 55330-8255 | 2020-10-01 |
| 1639786312 | Peter Wahl | Nurse Practitioner | 4652 Lyndale Ave S, Minneapolis, MN 55419-5302 | 2020-09-28 |
| 1568078616 | Joanna Kay Rehm | Nurse Practitioner | 3025 Eagandale Pl Apt 338, Eagan, MN 55121-1236 | 2020-09-23 |
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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.