| Jenni Hetletved, PA-C | |
|
1177 Border Ln, Washburn, ND 58577-4102 | |
| (701) 462-3396 | |
| Not Available |
| Full Name | Jenni Hetletved |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 3 Years |
| Location | 1177 Border Ln, Washburn, North Dakota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164207338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Garrison Memorial Hospital | Garrison, ND | Hospital |
| Chi St Alexius Health Turtle Lake | Turtle lake, ND | Hospital |
| Chi St. Alexius Health Garrison | Garrison, ND | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Alexius Medical Center | 8426960865 | 239 |
| Garrison Memorial Hospital | 0143206946 | 7 |
| Entity Name | St Alexius Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205868429 PECOS PAC ID: 8426960865 Enrollment ID: O20031104000146 |
| Entity Name | Garrison Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952381873 PECOS PAC ID: 0143206946 Enrollment ID: O20040624000556 |
| Entity Name | Garrison Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1982674560 PECOS PAC ID: 0143206946 Enrollment ID: O20061104000698 |
| Entity Name | St Alexius Medical Center |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1013961820 PECOS PAC ID: 8426960865 Enrollment ID: O20101029001339 |
| Mailing Address | Practice Location Address |
|---|---|
| Jenni Hetletved, PA-C 420 7th St, Washburn, ND 58577-4384 Ph: (701) 200-6551 | Jenni Hetletved, PA-C 1177 Border Ln, Washburn, ND 58577-4102 Ph: (701) 462-3396 |
Kaitlyn Rae Wirtz, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1177 Border Ln, Washburn, ND 58577 Phone: 701-462-3396 Fax: 701-463-3422 |