| Promed Preferred MN PLLC | |
|
202 N Cedar Ave Ste 1 Owatonna MN 55060-2306 | |
| (615) 499-3165 | |
| Not Available |
| Full Name | Promed Preferred MN PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 202 N Cedar Ave Ste 1, Owatonna, Minnesota |
| Authorized Official Name and Position | Lev Grinman (PRESIDENT) |
| Authorized Official Contact | 6154993165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Promed Preferred MN PLLC 46 Virginia Ave Monroe NY 10950-2214 | Promed Preferred MN PLLC 202 N Cedar Ave Ste 1 Owatonna MN 55060-2306 Ph: (615) 499-3165 |
| NPI Number | 1841057817 |
|---|---|
| Provider Enumeration Date | 03/05/2024 |
| Last Update Date | 08/03/2026 |
| Certification Date | 08/03/2026 |
| Medicare PECOS PAC ID | 3870008980 |
|---|---|
| Medicare Enrollment ID | O20250716002333 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841057817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Jennifer Otterbein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467425751 PECOS PAC ID: 8729042338 Enrollment ID: I20041115000102 |
| Provider Name | Megan Saltz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164318689 PECOS PAC ID: 9830604941 Enrollment ID: I20250716002448 |
| Provider Name | Brenda Siolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750782736 PECOS PAC ID: 0547572513 Enrollment ID: I20251212001841 |
| Provider Name | Amber Jaeger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700736642 PECOS PAC ID: 0446733943 Enrollment ID: I20260312002949 |
| Provider Name | Mia Amao Yang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578251088 PECOS PAC ID: 5597236109 Enrollment ID: I20260604002586 |
| Provider Name | Nicholas B Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609600568 PECOS PAC ID: 7012488653 Enrollment ID: I20260604003412 |
| Provider Name | Yvonne Stallard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447984430 PECOS PAC ID: 6406226331 Enrollment ID: I20260608001231 |
| Provider Name | Mai Xiong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124961495 PECOS PAC ID: 9931670270 Enrollment ID: I20260608001280 |
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