Katelin D Super (NPI# 1386168631, PAC ID# 5395019335) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1386168631 |
| PAC ID by PECOS | 5395019335 |
| Professional Enrollment ID | I20170914002515 |
| Full Name | Katelin D Super |
| Organization Legal Name | LIFESPRK MEDICAL GROUP PA |
| Address |
5320 W 23rd St Suite 130 St Louis Park MN 55416-1670 |
| Phone Number | 9523453213 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4385908201 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 240053 | PARK NICOLLET METHODIST HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 5320 W 23rd St, Suite 130, St Louis Park, MN 55416-1670 | 9523453213 | LIFESPRK MEDICAL GROUP PA |
| Organization Legal Name | LIFESPRK MEDICAL GROUP PA |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leann M Clarksean | Nurse Practitioner | Lifesprk Medical Group Pa | 5320 W 23rd St, Suite 130, St Louis Park, MN 55416-1670 |
| Annerhe C Erickson | Nurse Practitioner | Lifesprk Medical Group Pa | 5320 W 23rd St, Suite 130, St Louis Park, MN 55416-1670 |
| Teresa K Mccartney | Nurse Practitioner | Lifesprk Medical Group Pa | 5320 W 23rd St, Suite 130, St Louis Park, MN 55416-1670 |
| Catherine A Lauring | Nurse Practitioner | Lifesprk Medical Group Pa | 5320 W 23rd St, Suite 130, St Louis Park, MN 55416-1670 |
| Street Address |
5320 W 23RD ST SUITE 130 |
| City | ST LOUIS PARK |
| State | MN |
| Zip | 55416-1670 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leann M Clarksean | Nurse Practitioner | Lifesprk Medical Group Pa | 5320 W 23rd St, Suite 130, St Louis Park, MN 55416-1670 |
| Annerhe C Erickson | Nurse Practitioner | Lifesprk Medical Group Pa | 5320 W 23rd St, Suite 130, St Louis Park, MN 55416-1670 |
| Teresa K Mccartney | Nurse Practitioner | Lifesprk Medical Group Pa | 5320 W 23rd St, Suite 130, St Louis Park, MN 55416-1670 |
| Catherine A Lauring | Nurse Practitioner | Lifesprk Medical Group Pa | 5320 W 23rd St, Suite 130, St Louis Park, MN 55416-1670 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marian L Delaney | Physical Therapy | Fairview Health Services | 3033 Excelsior Blvd, Suite 225, Minneapolis, MN 55416-0026 |
| Melissa R Shirriff | Physical Therapy | Fairview Health Services | 3033 Excelsior Blvd, Suite 225, Minneapolis, MN 55416-0026 |
| Harlan F Mittag | Chiropractic | 6311 Wayzata Blvd, Suite 220, St Louis Park, MN 55416-1245 | |
| Keith Alan Vossel | Neurology | University of Minnesota Physicians | 5775 Wayzata Blvd, Suite 255, St Louis Park, MN 55416-1275 |
| Kayla Charlene James | Clinical Social Worker | University of Minnesota Physicians | 5775 Wayzata Blvd, Suite 255, St Louis Park, MN 55416-1275 |
| Shauna Hsiaosan Yuan | Neurology | University of Minnesota Physicians | 5775 Wayzata Blvd, Suite 255, St Louis Park, MN 55416-1275 |
| Christa Joyce Reader | Clinical Social Worker | University of Minnesota Physicians | 5775 Wayzata Blvd, Suite 255, St Louis Park, MN 55416-1275 |
| Scott Curran | Clinical Social Worker | University of Minnesota Physicians | 5775 Wayzata Blvd, Suite 255, St Louis Park, MN 55416-1275 |
| James Ashe | Neurology | University of Minnesota Physicians | 5775 Wayzata Blvd, Minneapolis, MN 55416-1275 |
| Kathryn Ann Gorres Nice | Occupational Therapy | University of Minnesota Physicians | 5775 Wayzata Blvd, Suite 255, St Louis Park, MN 55416-1275 |
| Find all physicians in zip 55416 | |||
| City | ST LOUIS PARK |
| Zip Code | 55416 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | ST LOUIS PARK + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Katelin D Super.
| 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.