Jennifer A Prom (NPI# 1215948781, PAC ID# 1658381710) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1215948781 |
| PAC ID by PECOS | 1658381710 |
| Professional Enrollment ID | I20060503000634 |
| Full Name | Jennifer A Prom |
| Organization Legal Name | ST LUKES HOSPITAL OF DULUTH |
| Address |
1400 Woodland Ave Duluth MN 55803-2624 |
| Phone Number | 2182498800 |
| Gender | F |
| Credential | PA |
| Graduation Year | 2005 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 7113834839 |
| Number of Group Practice Members | 341 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 240047 | ST LUKES HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1012 E 2nd St, Duluth, MN 55805-2200 | ST LUKES HOSPITAL OF DULUTH | |
| 1400 Woodland Ave, Duluth, MN 55803-2624 | 2182498800 | ST LUKES HOSPITAL OF DULUTH |
| 2101 Trinity Rd, Duluth, MN 55811-3349 | 2182497520 | ST LUKES HOSPITAL OF DULUTH |
| 4190 Loberg Ave, Duluth, MN 55811-2652 | 2182494600 | ST LUKES HOSPITAL OF DULUTH |
| 619 W Central Entrance, Duluth, MN 55811-5448 | 2182494987 | ST LUKES HOSPITAL OF DULUTH |
| 915 E 1st St, Duluth, MN 55805-2107 | 2182495555 | ST LUKES HOSPITAL OF DULUTH |
| 109 N 28th St E, Superior, WI 54880-6548 | 7153953950 | ST LUKES HOSPITAL OF DULUTH |
| Organization Legal Name | ST LUKES HOSPITAL OF DULUTH |
| Physicians | 314 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth M Lafrance | Physician Assistant | St Lukes Hospital of Duluth | 1400 Woodland Ave, Duluth, MN 55803-2624 |
| Nichole Marie Dorn | Nurse Practitioner | St Lukes Hospital of Duluth | 619 W Central Entrance, Duluth, MN 55811-5448 |
| Bari S Hillman | Psychologist, Clinical | St Lukes Hospital of Duluth | 26 E Superior St, Suite 205, Duluth, MN 55802-2196 |
| Sally L Bruestle | Physician Assistant | St Lukes Hospital of Duluth | 50 Outer Dr, Silver Bay, MN 55614-1102 |
| Pamela B Landsteiner | Dermatology | St Lukes Hospital of Duluth | 920 E 1st St, Suite 201, Duluth, MN 55805-2215 |
| Dana R Katchka | Nurse Practitioner | St Lukes Hospital of Duluth | 2201 Lake Shore Dr E, Ashland, WI 54806-2331 |
| Tara L Richter | Psychologist, Clinical | St Lukes Hospital of Duluth | 220 N 6th Ave E, Duluth, MN 55805-1952 |
| Megan J Hoel | Family Medicine | St Lukes Hospital of Duluth | 109 N 28th St E, Superior, WI 54880-6548 |
| Erin R Thielbar | Nurse Practitioner | St Lukes Hospital of Duluth | 8373 Unity Dr, Virginia, MN 55792-4005 |
| Elisabeth Jane Gibbons | Family Medicine | St Lukes Hospital of Duluth | 4702 Grand Ave, Duluth, MN 55807-2742 |
| Street Address |
1400 WOODLAND AVE |
| City | DULUTH |
| State | MN |
| Zip | 55803-2624 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth M Lafrance | Physician Assistant | St Lukes Hospital of Duluth | 1400 Woodland Ave, Duluth, MN 55803-2624 |
| Lindsay Marie Johnson | Nurse Practitioner | St Lukes Hospital of Duluth | 1400 Woodland Ave, Duluth, MN 55803-2624 |
| Suzanne Anderson | Nurse Practitioner | St Lukes Hospital of Duluth | 1400 Woodland Ave, Duluth, MN 55803-2624 |
| Kelsea N Pearson | Physician Assistant | St Lukes Hospital of Duluth | 1400 Woodland Ave, Duluth, MN 55803-2624 |
| Lori Gw Lindgren | Nurse Practitioner | St Lukes Hospital of Duluth | 1400 Woodland Ave, Duluth, MN 55803-2624 |
| Carl P. Rasmussen | Family Medicine | St Lukes Hospital of Duluth | 1400 Woodland Ave, Duluth, MN 55803-2624 |
| Anna C Greiner | Physician Assistant | St. Luke's Hospital of Duluth | 1400 Woodland Ave, Duluth, MN 55803-2624 |
| Patricia L Earley | Nurse Practitioner | St. Luke's Hospital of Duluth | 1400 Woodland Ave, Duluth, MN 55803-2624 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kaitlyn M Bhoopal | Nurse Practitioner | Twin Ports Dermatology Inc | 1414 Woodland Ave, Duluth, MN 55803-2624 |
| Jeffrey Neil Samuelson | Dermatology | Twin Ports Dermatology Inc | 1414 Woodland Ave, Duluth, MN 55803-2624 |
| Amy J Larson | Nurse Practitioner | Twin Ports Dermatology Inc | 1414 Woodland Ave, Duluth, MN 55803-2624 |
| Cynthia Y Eaton | Nurse Practitioner | Twin Ports Dermatology Inc | 1414 Woodland Ave, Duluth, MN 55803-2624 |
| Cameron West | Dermatology | Twin Ports Dermatology Inc | 1414 Woodland Ave, Duluth, MN 55803-2624 |
| Amy M Oakes | Physical Therapy | Therapy Partners Inc | 66 E Saint Marie St, Duluth, MN 55803-2646 |
| Inna Korablina | Occupational Therapy | Therapy Partners Inc | 66 E Saint Marie St, Duluth, MN 55803-2646 |
| Amelie J Lindberg-livingston | Physical Therapy | Therapy Partners Inc | 66 E Saint Marie St, Duluth, MN 55803-2646 |
| Kathryn M Donovan | Chiropractic | 4961 Rice Lake Rd, Suite 103, Duluth, MN 55803-8439 |
| City | DULUTH |
| Zip Code | 55803 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | DULUTH + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Jennifer A Prom.
| 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.