| Dr Amy Beth Vislisel, MD | |
|
5200 Fairview Blvd, Wyoming, MN 55092-8013 | |
| (651) 982-7000 | |
| Not Available |
| Full Name | Dr Amy Beth Vislisel |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 5200 Fairview Blvd, Wyoming, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952537979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | FV3038165 (Minnesota) | Primary |
| Entity Name | Fairview Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013994359 PECOS PAC ID: 1951213057 Enrollment ID: O20031105000461 |
| Entity Name | Fairview Clinics |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346432218 PECOS PAC ID: 7113830142 Enrollment ID: O20031106000516 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Amy Beth Vislisel, MD 5200 Fairview Blvd, Wyoming, MN 55092-8013 Ph: (651) 982-7000 | Dr Amy Beth Vislisel, MD 5200 Fairview Blvd, Wyoming, MN 55092-8013 Ph: (651) 982-7000 |
Sarah Connaughty Fuerstenberg, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5200 Fairview Blvd, Wyoming, MN 55092 Phone: 651-982-7000 | |
Mani Mokalla, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5200 Fairview Blvd, Wyoming, MN 55092 Phone: 651-982-7000 | |
Benjamin Stanghelle, MD Pediatrics Medicare: May Accept Medicare Assignments Practice Location: 5200 Fairview Blvd, Wyoming, MN 55092 Phone: 651-982-7000 | |
Kevin Anthony Brueske, Pediatrics Medicare: Medicare Enrolled Practice Location: 5200 Fairview Blvd, Wyoming, MN 55092 Phone: 651-982-7000 | |
Scott Ward Ahrenholz, D.O. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 5200 Fairview Blvd, Wyoming, MN 55092 Phone: 651-982-7800 Fax: 651-982-7539 | |
Sarah Barnes Kinsella, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 5200 Fairview Blvd, Wyoming, MN 55092 Phone: 651-982-7600 |