Mrs Olitha Jamesetta Fofana, AGPCNP-BC in Champlin, MN

Mrs Olitha Jamesetta Fofana, AGPCNP-BC is a medicare enrolled "Nurse Practitioner - Adult Health" in Champlin, Minnesota. She went to University Of South Alabama College Of Medicine and graduated in 2014 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Park Nicollet Clinic and her current practice location is 10911 Rhode Island Cir N, Champlin, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 493-2947.

Mrs Olitha Jamesetta Fofana is licensed to practice in Minnesota (license number CNP 3783) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1013301407.

Contact Information

	Mrs Olitha Jamesetta Fofana, AGPCNP-BC
	10911 Rhode Island Cir N, Champlin, MN 55316-3256
	(763) 493-2947
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Olitha Jamesetta Fofana
Gender	Female
Speciality	Nurse Practitioner
Experience	10 Years
Location	10911 Rhode Island Cir N, Champlin, 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.

Medical Education and Training:

Mrs Olitha Jamesetta Fofana attended and graduated from University Of South Alabama College Of Medicine in 2014

NPI Data:

NPI Number: 1013301407
Provider Enumeration Date: 03/24/2015
Last Update Date: 03/24/2015

Medicare PECOS Information:

PECOS PAC ID: 1254643349
Enrollment ID: I20150701002832

Medical Identifiers

Medical identifiers for Mrs Olitha Jamesetta Fofana such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013301407	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2200X	Nurse Practitioner - Adult Health	CNP 3783 (Minnesota)	Primary
363LG0600X	Nurse Practitioner - Gerontology	CNP 3783 (Minnesota)	Secondary
363LP2300X	Nurse Practitioner - Primary Care	CNP 3783 (Minnesota)	Secondary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Interim Healthcare Of The Twin Cities	Roseville, MN	Home health agency
Park Nicollet Methodist Hospital	Saint louis park, MN	Hospice
Park Nicollet Methodist Hospital	Saint louis park, MN	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Park Nicollet Clinic	7911819438	1529

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Olitha Jamesetta Fofana allows following entities to bill medicare on her behalf.

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	Noble Parkway Medical Clinic Professional Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043556517 PECOS PAC ID: 8921245689 Enrollment ID: O20130516000538

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Olitha Jamesetta Fofana is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Olitha Jamesetta Fofana, AGPCNP-BC 10911 Rhode Island Cir N, Champlin, MN 55316-3256 Ph: (763) 493-2947	Mrs Olitha Jamesetta Fofana, AGPCNP-BC 10911 Rhode Island Cir N, Champlin, MN 55316-3256 Ph: (763) 493-2947

Reviews and Comments

Nurse Practitioner Nurses in Champlin, MN

Prince Nde Aloh, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 11269 Jefferson Hwy N, Champlin, MN 55316 Phone: 763-236-0600
Holly M Jensrud, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11269 Jefferson Hwy N, Champlin, MN 55316 Phone: 763-236-0600 Fax: 763-427-0790
Janet M Siciliano, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11269 Jefferson Hwy N, Champlin, MN 55316 Phone: 612-427-9620 Fax: 612-247-9626
Mrs. Amy Rasmussen, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11269 Jefferson Hwy N Fl 1, Champlin, MN 55316 Phone: 651-503-1994
Micah Nicole Vande Vegte, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 220 E River Pkwy Unit 428, Champlin, MN 55316 Phone: 712-395-8621
Mrs. Jan Elaine Youngblood, APRN, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11990 Business Park Blvd N, Champlin, MN 55316 Phone: 402-598-2365

Mrs Olitha Jamesetta Fofana, AGPCNP-BC - Medicare Nurse Practitioner in Champlin, MN