Joellen M Kohlman Petrick (NPI# 1114985454, PAC ID# 6103091129) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CARDIOVASCULAR DISEASE (CARDIOLOGY).
| Nation Provider ID (NPI) | 1114985454 |
| PAC ID by PECOS | 6103091129 |
| Professional Enrollment ID | I20120614000709 |
| Full Name | Joellen M Kohlman Petrick |
| Organization Legal Name | LAKE REGION HEALTHCARE CORPORATION |
| Address |
410 S Lake Ave Battle Lake MN 56515-4238 |
| Phone Number | 2188645283 |
| Gender | F |
| Medical School | UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE |
| Graduation Year | 2004 |
| Primary Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 3971565334 |
| Number of Group Practice Members | 87 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 240052 | LAKE REGION HEALTHCARE CORPORATION |
| 350011 | SANFORD MEDICAL CENTER FARGO |
| 241379 | PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES |
| Address | Phone | Organization |
|---|---|---|
| 410 S Lake Ave, Battle Lake, MN 56515-4238 | 2188645283 | LAKE REGION HEALTHCARE CORPORATION |
| 2311 W Lincoln Ave, Fergus Falls, MN 56537-1064 | 2187396800 | LAKE REGION HEALTHCARE CORPORATION |
| 712 S Cascade St, Fergus Falls, MN 56537-2913 | 2187368000 | LAKE REGION HEALTHCARE CORPORATION |
| Organization Legal Name | LAKE REGION HEALTHCARE CORPORATION |
| Physicians | 89 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Katie M Martin | Nurse Practitioner | Lake Region Healthcare Corporation | 209 2nd St Se, Barnesville, MN 56514 |
| Alena R Deutschlander | Nurse Practitioner | Lake Region Healthcare Corporation | 2311 W Lincoln Ave, Fergus Falls, MN 56537-1064 |
| Joel J Anderson | Nurse Practitioner | Lake Region Healthcare Corporation | 712 S Cascade St, Fergus Falls, MN 56537-2913 |
| Sheryl Olson | Nurse Practitioner | Lake Region Healthcare Corporation | 410 S Lake Ave, Battle Lake, MN 56515-4238 |
| Tyler L Scott | Certified Registered Nurse Anesthetist (crna) | Lake Region Healthcare Corporation | 712 S Cascade St, Fergus Falls, MN 56537-2913 |
| Steven B Thom | Ophthalmology | Lake Region Healthcare Corporation | 712 S Cascade St, Fergus Falls, MN 56537-2913 |
| Lonnie W Berger | Family Medicine | Lake Region Healthcare Corporation | 712 S Cascade St, Fergus Falls, MN 56537-2913 |
| Julianne D Gutzmer | General Surgery | Lake Region Healthcare Corporation | 712 S Cascade St, Fergus Falls, MN 56537-2913 |
| Heidi A Ottenbacher | Optometry | Lake Region Healthcare Corporation | 712 S Cascade St, Fergus Falls, MN 56537-2913 |
| Matthew James Mouser | Internal Medicine | Lake Region Healthcare Corporation | 712 S Cascade St, Fergus Falls, MN 56537-2913 |
| Street Address |
410 S LAKE AVE |
| City | BATTLE LAKE |
| State | MN |
| Zip | 56515-4238 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sheryl Olson | Nurse Practitioner | Lake Region Healthcare Corporation | 410 S Lake Ave, Battle Lake, MN 56515-4238 |
| Kiana M Deal | Physician Assistant | Lake Region Healthcare Corporation | 410 S Lake Ave, Battle Lake, MN 56515-4238 |
| Erin L Peterson | Internal Medicine | Lake Region Healthcare Corporation | 410 S Lake Ave, Battle Lake, MN 56515-4238 |
| Gregory M Smith | Pathology | Lake Region Healthcare Corporation | 410 S Lake Ave, Battle Lake, MN 56515-4238 |
| Daniel L Lembcke | Family Practice | Lake Region Healthcare Corporation | 410 S Lake Ave, Battle Lake, MN 56515-4238 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott E Ellingson | Chiropractic | 202 Lake S Ave, Battle Lake, MN 56515 | |
| John G Chase | Nurse Practitioner | 104 Memory Ln, Battle Lake, MN 56515-4242 |
| City | BATTLE LAKE |
| Zip Code | 56515 |
| Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| City + Specialty | BATTLE LAKE + CARDIOVASCULAR DISEASE (CARDIOLOGY) |
Please comment or provide details below to improve the information on Joellen M Kohlman Petrick.
| 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.