Jackie Lyn Micklewright (NPI# 1669705638, PAC ID# 0345411674) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHOLOGIST, CLINICAL.
| Nation Provider ID (NPI) | 1669705638 |
| PAC ID by PECOS | 0345411674 |
| Professional Enrollment ID | I20110919000350 |
| Full Name | Jackie Lyn Micklewright |
| Organization Legal Name | HEALTHWISE PSYCHOLOGY PA |
| Address |
11280 86th Ave N Maple Grove MN 55369-4510 |
| Phone Number | 7634007828 |
| Gender | F |
| Graduation Year | 2009 |
| Primary Specialty | PSYCHOLOGIST, CLINICAL |
| Group Practice PAC ID | 2567685647 |
| Number of Group Practice Members | 14 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 11280 86th Ave N, Maple Grove, MN 55369-4510 | 7634007828 | HEALTHWISE PSYCHOLOGY PA |
| 1700 University Ave W, Saint Paul, MN 55104-3727 | HEALTHEAST MEDICAL RESEARCH INSTITUTE | |
| 559 Capitol Blvd, Saint Paul, MN 55103-2101 | HEALTHEAST MEDICAL RESEARCH INSTITUTE |
| Organization Legal Name | HEALTHWISE PSYCHOLOGY PA |
| Physicians | 16 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kathryn Angela Schuster | Clinical Social Worker | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Natalie N Brandsrud | Nurse Practitioner | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Kristin Beth Dahl | Psychologist, Clinical | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Janice Eilene Beauduy | Family Medicine | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Kirsten M Wyffels | Nurse Practitioner | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Rebecca Ruth Fischer | Psychologist, Clinical | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Heidi Catrice Kopacek | Psychologist, Clinical | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Lauren M Snyder | Clinical Social Worker | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Nicole M Marcouiller | Clinical Social Worker | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Marci M Mueller Theisen | Psychologist, Clinical | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Street Address |
11280 86TH AVE N |
| City | MAPLE GROVE |
| State | MN |
| Zip | 55369-4510 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kathryn Angela Schuster | Clinical Social Worker | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Natalie N Brandsrud | Nurse Practitioner | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Kristin Beth Dahl | Psychologist, Clinical | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Janice Eilene Beauduy | Family Medicine | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Kirsten M Wyffels | Nurse Practitioner | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Rebecca Ruth Fischer | Psychologist, Clinical | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Heidi Catrice Kopacek | Psychologist, Clinical | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Lauren M Snyder | Clinical Social Worker | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Nicole M Marcouiller | Clinical Social Worker | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Marci M Mueller Theisen | Psychologist, Clinical | Healthwise Psychology Pa | 11280 86th Ave N, Maple Grove, MN 55369-4510 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Heidi J Hill | Qualified Audiologist | 512 Central Ave, Osseo, MN 55369-1129 | |
| Kristin Lori Kipka | Family Medicine | North Clinic, Pa | 50 Central Ave, Osseo, MN 55369-1241 |
| Mancel T Mitchell Iii | Family Medicine | North Clinic, Pa | 50 Central Ave, Osseo, MN 55369-1241 |
| Moushumi Meher | Family Medicine | North Clinic, Pa | 50 Central Ave, Osseo, MN 55369-1241 |
| Jennifer M Berger | Physician Assistant | North Clinic, Pa | 50 Central Ave, Osseo, MN 55369-1241 |
| Neil P Jeddeloh | Family Medicine | North Clinic, Pa | 50 Central Ave, Osseo, MN 55369-1241 |
| Paul A Ruth | Family Medicine | North Clinic, Pa | 50 Central Ave, Osseo, MN 55369-1241 |
| Darrell A Krieger | Internal Medicine | North Clinic, Pa | 50 Central Ave, Osseo, MN 55369-1241 |
| Kevin Raff | Family Medicine | North Clinic, Pa | 50 Central Ave, Osseo, MN 55369-1241 |
| Vandana Gupta | Internal Medicine | North Clinic, Pa | 50 Central Ave, Osseo, MN 55369-1241 |
| Find all physicians in zip 55369 | |||
| City | MAPLE GROVE |
| Zip Code | 55369 |
| Specialty | PSYCHOLOGIST, CLINICAL |
| City + Specialty | MAPLE GROVE + PSYCHOLOGIST, CLINICAL |
Please comment or provide details below to improve the information on Jackie Lyn Micklewright.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.