| Miranda Marie Fassbender, | |
|
230 Deronda St, Amery, WI 54001-1412 | |
| (715) 268-8000 | |
| Not Available |
| Full Name | Miranda Marie Fassbender |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 230 Deronda St, Amery, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356681308 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 1887 (Minnesota) | Secondary |
| 101YP2500X | Counselor - Professional | 5640.125 (Wisconsin) | Primary |
| Entity Name | Amery Regional Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093763518 PECOS PAC ID: 2769391960 Enrollment ID: O20040131000207 |
| Mailing Address | Practice Location Address |
|---|---|
| Miranda Marie Fassbender, 2265 Como Ave, Saint Paul, MN 55108-1737 Ph: (651) 645-5323 | Miranda Marie Fassbender, 230 Deronda St, Amery, WI 54001-1412 Ph: (715) 268-8000 |
Linda Christine Mueller, Counselor Medicare: Not Enrolled in Medicare Practice Location: 236 Griffin, Amery, WI 54001 Phone: 715-268-8000 | |
Emily Jane Schueller, AAS, SACIT Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 Deronda St, Amery, WI 54001 Phone: 715-268-0060 | |
Ashley Hinzman, SAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 Deronda St, Amery, WI 54001 Phone: 715-268-0060 Fax: 715-268-0061 | |
Brian C Francis, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 Deronda St, Amery, WI 54001 Phone: 715-268-0136 Fax: 715-268-0061 | |
Jeffrey Coleman Lund, Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 Deronda St, Amery, WI 54001 Phone: 715-268-8000 | |
Deborah K Rogers, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 225 Scholl Ct, Amery, WI 54001 Phone: 715-327-4402 Fax: 715-327-8509 |