| Amanda Elizabeth Leino, MD | |
|
1805 Hennepin Ave N, Glencoe, MN 55336-1416 | |
| (320) 864-3121 | |
| (320) 864-7887 |
| Full Name | Amanda Elizabeth Leino |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 1805 Hennepin Ave N, Glencoe, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598754335 | NPI | - | NPPES |
| 741127800 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 44767 (Minnesota) | Primary |
| Entity Name | Park Nicollet Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
| Entity Name | Glencoe Regional Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508885633 PECOS PAC ID: 1759292980 Enrollment ID: O20031119000252 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Elizabeth Leino, MD 1805 Hennepin Ave N, Glencoe, MN 55336-1416 Ph: (320) 864-3121 | Amanda Elizabeth Leino, MD 1805 Hennepin Ave N, Glencoe, MN 55336-1416 Ph: (320) 864-3121 |
Timothy F Lane, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1805 Hennepin Ave N, Glencoe, MN 55336 Phone: 320-864-3121 | |
Michael Patrick Mccarthy, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1805 Hennepin Ave N, Glencoe, MN 55336 Phone: 320-864-3121 Fax: 320-864-7887 | |
James W Jessen, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1805 Hennepin Ave N, Glencoe, MN 55336 Phone: 320-864-3121 | |
Laura Jean Olson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1805 Hennepin Ave North, Glencoe Regional Health Services, Glencoe, MN 55336 Phone: 320-864-3121 Fax: 320-864-7887 | |
Kristine Leonard Knudten, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1805 Hennepin Ave North, Glencoe, MN 55336 Phone: 320-864-3121 Fax: 320-864-7887 | |
Douglas Lee Wagoner, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1805 Hennepin Ave N, Glencoe Regional Health Services, Glencoe, MN 55336 Phone: 320-864-3121 Fax: 320-864-7887 | |
Bryan Tutt Petersen, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1805 Hennepin Ave N, Glencoe Regional Health Services, Glencoe, MN 55336 Phone: 320-864-3121 Fax: 320-864-7887 |