| Kelly Korene White, CNP | |
|
25945 Gateway Dr, Zimmerman, MN 55398-5300 | |
| (763) 856-6900 | |
| Not Available |
| Full Name | Kelly Korene White |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 12 Years |
| Location | 25945 Gateway Dr, Zimmerman, Minnesota |
| 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 |
|---|---|---|---|
| 1417293572 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | R 147784-9 (Minnesota) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | CNP 2080 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fairview Northland Regional Hospital | Princeton, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fairview Clinics | 7113830142 | 736 |
| 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 |
| Entity Name | Fairview Express Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Korene White, CNP 25945 Gateway Dr, Zimmerman, MN 55398-5300 Ph: (763) 856-6900 | Kelly Korene White, CNP 25945 Gateway Dr, Zimmerman, MN 55398-5300 Ph: (763) 856-6900 |
Kathryn Thompson, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13139 Lake Place Rd, Zimmerman, MN 55398 Phone: 701-260-5358 Fax: 763-856-2773 | |
Wendy Sabinske, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 25082 117th St Nw, Zimmerman, MN 55398 Phone: 763-218-8188 | |
Mikayla Ellen Siemsen, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 12025 276th Ave Nw, Zimmerman, MN 55398 Phone: 763-350-6676 |