| Sanford Health Of Northern Minnesota | |
|
111 2nd St Ne, Fosston, MN 56542-1301 | |
| (218) 435-1010 | |
| (218) 435-1715 |
| Full Name | Sanford Health Of Northern Minnesota |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 111 2nd St Ne, Fosston, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265829881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Sara A Fredrickson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407880057 PECOS PAC ID: 7214982511 Enrollment ID: I20050321000169 |
| Provider Name | Samuel R Sant |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740327493 PECOS PAC ID: 8628008638 Enrollment ID: I20050819000156 |
| Provider Name | Andrew A Jordan |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1992723563 PECOS PAC ID: 1850345299 Enrollment ID: I20060123000834 |
| Provider Name | Germaine E Cheslock |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154468890 PECOS PAC ID: 9335240191 Enrollment ID: I20070723000840 |
| Provider Name | Pamela M Samson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760403984 PECOS PAC ID: 1153414818 Enrollment ID: I20070911000702 |
| Provider Name | Staci Lynn Collison |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588949648 PECOS PAC ID: 6002036589 Enrollment ID: I20141003002230 |
| Provider Name | Derek David Czywczynski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427281583 PECOS PAC ID: 0648316646 Enrollment ID: I20200521000589 |
| Provider Name | Kelly Pruett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336217900 PECOS PAC ID: 4385817691 Enrollment ID: I20210204000116 |
| Mailing Address | Practice Location Address |
|---|---|
| Sanford Health Of Northern Minnesota Po Box 5074, Sioux Falls, SD 57117-5074 Ph: (605) 328-6585 | Sanford Health Of Northern Minnesota 111 2nd St Ne, Fosston, MN 56542-1301 Ph: (218) 435-1010 |
Bradley W Neujahr Od Pa Optometrist Medicare: Not Enrolled in Medicare Practice Location: 111 2nd St Ne, Fosston, MN 56542 Phone: 218-435-1010 Fax: 218-435-1715 |