| Sanford Health Broadway Clinic | |
|
1527 Broadway St Alexandria MN 56308-2537 | |
| (320) 762-0399 | |
| (320) 762-6847 |
| Full Name | Sanford Health Broadway Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1527 Broadway St, Alexandria, Minnesota |
| Authorized Official Name and Position | Martha K Leclerc (VICE PRESIDENT) |
| Authorized Official Contact | 7012346248 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanford Health Broadway Clinic Po Box 5074 Sioux Falls SD 57117-5074 Ph: (605) 328-6585 | Sanford Health Broadway Clinic 1527 Broadway St Alexandria MN 56308-2537 Ph: (320) 762-0399 |
| NPI Number | 1548532468 |
|---|---|
| Provider Enumeration Date | 02/08/2012 |
| Last Update Date | 01/27/2021 |
| Medicare PECOS PAC ID | 4284546151 |
|---|---|
| Medicare Enrollment ID | O20031209000264 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548532468 | NPI | - | NPPES |
| 379186602 | Other | MN | FEDERAL WORKERS COMP |
| DS4138 | Other | MN | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Andrew J Hvidston |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477505725 PECOS PAC ID: 4486559317 Enrollment ID: I20031204000342 |
| Provider Name | Matthew J Nelsen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1699727958 PECOS PAC ID: 0648175471 Enrollment ID: I20031204000400 |
| Provider Name | Donald W Preussler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215955810 PECOS PAC ID: 8325949092 Enrollment ID: I20040115000934 |
| Provider Name | William N Klava |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1174544308 PECOS PAC ID: 9931001823 Enrollment ID: I20040122000100 |
| Provider Name | Richard L Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952361636 PECOS PAC ID: 3577465988 Enrollment ID: I20040126000405 |
| Provider Name | Daniel G Mickelson |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1215954854 PECOS PAC ID: 4587566831 Enrollment ID: I20040126000725 |
| Provider Name | Daniel W Louvar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1912984923 PECOS PAC ID: 0345143293 Enrollment ID: I20040129000148 |
| Provider Name | Sultan Michael |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346330412 PECOS PAC ID: 6709771132 Enrollment ID: I20040216000959 |
| Provider Name | Kevin D Ballard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700825981 PECOS PAC ID: 2860388931 Enrollment ID: I20040225000718 |
| Provider Name | Andrea Beth Jolley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154301463 PECOS PAC ID: 2668377656 Enrollment ID: I20040228000179 |
| Provider Name | Arndt Beroen Braaten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053488452 PECOS PAC ID: 1153318779 Enrollment ID: I20040427000640 |
| Provider Name | John H Imsande |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245283787 PECOS PAC ID: 1850388943 Enrollment ID: I20040429000922 |
| Provider Name | Francis Noel Leblanc |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881652493 PECOS PAC ID: 1254320815 Enrollment ID: I20040510000029 |
| Provider Name | Mary L Rymanowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871565929 PECOS PAC ID: 0840280897 Enrollment ID: I20040513000370 |
| Provider Name | Julie A Thompson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962462085 PECOS PAC ID: 7416947288 Enrollment ID: I20040513001277 |
| Provider Name | Suzanne L Human |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326080649 PECOS PAC ID: 6901897594 Enrollment ID: I20040521000731 |
| Provider Name | Jon D Larson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508884172 PECOS PAC ID: 1355323635 Enrollment ID: I20040601001446 |
| Provider Name | Scott A Sundby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376513770 PECOS PAC ID: 5597747162 Enrollment ID: I20040607000505 |
| Provider Name | Bruce A Evink |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518937911 PECOS PAC ID: 3779565361 Enrollment ID: I20040607000633 |
| Provider Name | Randel T Stolee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730100959 PECOS PAC ID: 3375515539 Enrollment ID: I20040809000591 |
| Provider Name | Preston D Steen |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1124053285 PECOS PAC ID: 5395718696 Enrollment ID: I20040816000542 |
| Provider Name | Julie A Spina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194747758 PECOS PAC ID: 2860467495 Enrollment ID: I20040827000728 |
| Provider Name | Jaimie J Deraney |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629096367 PECOS PAC ID: 3476528001 Enrollment ID: I20040827000748 |
| Provider Name | Tina M Lundeen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023030517 PECOS PAC ID: 3779558317 Enrollment ID: I20040827000808 |
| Provider Name | David A Vanengelenhoven |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093775900 PECOS PAC ID: 5991772717 Enrollment ID: I20040913000272 |
| Provider Name | Brian D Nelson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881683696 PECOS PAC ID: 4880655232 Enrollment ID: I20041020000366 |
| Provider Name | Jawad H Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083657035 PECOS PAC ID: 4981666195 Enrollment ID: I20041101000015 |
| Provider Name | Julie J Miller |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1144291352 PECOS PAC ID: 5395707434 Enrollment ID: I20041101000313 |
| Provider Name | Mark J Carlson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619904794 PECOS PAC ID: 6507829314 Enrollment ID: I20041111000483 |
| Provider Name | Mark Roger Paulson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295766392 PECOS PAC ID: 2365407129 Enrollment ID: I20041122000597 |
| Provider Name | Mark E Berntson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508807116 PECOS PAC ID: 4385601020 Enrollment ID: I20041215000063 |
| Provider Name | Rachel Ann Koch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245279835 PECOS PAC ID: 9436117306 Enrollment ID: I20041222000753 |
| Provider Name | Isaac Joseph Schaan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558480988 PECOS PAC ID: 6800854795 Enrollment ID: I20041223000017 |
| Provider Name | Talitha M Sannes-venhuizen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306887286 PECOS PAC ID: 3375591175 Enrollment ID: I20050108000024 |
| Provider Name | Curtis C Krueger |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952341026 PECOS PAC ID: 3274501192 Enrollment ID: I20050321000137 |
| Provider Name | Ronald Miles Burd |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750308755 PECOS PAC ID: 0143267252 Enrollment ID: I20050411000805 |
| Provider Name | Danae Jb Lund |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366449639 PECOS PAC ID: 1658319207 Enrollment ID: I20050422000951 |
| Provider Name | Richard L Catalan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194771097 PECOS PAC ID: 8426047010 Enrollment ID: I20050429000128 |
| Provider Name | Sharon R Cannon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578580577 PECOS PAC ID: 6507807609 Enrollment ID: I20050519000093 |
| Provider Name | Jason J Caron |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114070182 PECOS PAC ID: 0840236766 Enrollment ID: I20050630000856 |
| Provider Name | William L Bock |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295753994 PECOS PAC ID: 1456397991 Enrollment ID: I20050706000461 |
| Provider Name | Rwanda D Campbell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174599641 PECOS PAC ID: 5799713129 Enrollment ID: I20050727001129 |
| Provider Name | Lori A Sutherland |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154378529 PECOS PAC ID: 8022047299 Enrollment ID: I20050808000923 |
| Provider Name | Samuel R Sant |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740327493 PECOS PAC ID: 8628008638 Enrollment ID: I20050819000156 |
| Provider Name | Johanna R Askegard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083694608 PECOS PAC ID: 7517990658 Enrollment ID: I20050919000120 |
| Provider Name | Ferdinand R Makalinao |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275504383 PECOS PAC ID: 7911926472 Enrollment ID: I20051115000272 |
| Provider Name | Maria L Patacsil |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1205807310 PECOS PAC ID: 1355360710 Enrollment ID: I20051115000304 |
| Provider Name | Delayna A Nitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780662544 PECOS PAC ID: 3971522160 Enrollment ID: I20051116000991 |
| Provider Name | Craig H Haggerty |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760409627 PECOS PAC ID: 1658391453 Enrollment ID: I20051122000747 |
| Provider Name | Daniel P Dekrey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154349702 PECOS PAC ID: 8820018633 Enrollment ID: I20051122000771 |
| Provider Name | Rodney D Will |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033131628 PECOS PAC ID: 9537189345 Enrollment ID: I20051122000786 |
| Provider Name | Kris Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558389296 PECOS PAC ID: 2668433236 Enrollment ID: I20051122000805 |
| Provider Name | Alicia A Frankwitz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720027303 PECOS PAC ID: 9234159450 Enrollment ID: I20051202000518 |
| Provider Name | Todd Gunnar Holmes |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1588720544 PECOS PAC ID: 4981627924 Enrollment ID: I20060105000426 |
| Provider Name | Taylor F Dowsley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518926534 PECOS PAC ID: 8426063124 Enrollment ID: I20060216000465 |
| Provider Name | Jon Edwin Bradbury |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679514285 PECOS PAC ID: 8123034907 Enrollment ID: I20060306000708 |
| Provider Name | Patrick J Schweiger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578573275 PECOS PAC ID: 8426066044 Enrollment ID: I20060323000443 |
| Provider Name | Stephen P Nordmark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427075985 PECOS PAC ID: 2860400041 Enrollment ID: I20060329000720 |
| Provider Name | Timothy R Beiswenger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588681571 PECOS PAC ID: 8628087707 Enrollment ID: I20060418000592 |
| Provider Name | Scott W Petrescue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043302474 PECOS PAC ID: 5890608038 Enrollment ID: I20060428000500 |
| Provider Name | David B Paul |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528056595 PECOS PAC ID: 3072525104 Enrollment ID: I20060608000048 |
| Provider Name | Billie J Grieve |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598700882 PECOS PAC ID: 1254344575 Enrollment ID: I20060802000517 |
| Provider Name | Eric C Pearson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003835984 PECOS PAC ID: 7719914217 Enrollment ID: I20060823000369 |
| Provider Name | Anu G Gaba |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1922025907 PECOS PAC ID: 6103807920 Enrollment ID: I20060829000508 |
| Provider Name | Alyssa R Hoverson Schott |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1982613246 PECOS PAC ID: 3577567585 Enrollment ID: I20060906000252 |
| Provider Name | Nancy J Stock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144248212 PECOS PAC ID: 6002811106 Enrollment ID: I20060925000067 |
| Provider Name | Gail Y Pickett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235177841 PECOS PAC ID: 5092710822 Enrollment ID: I20060928000411 |
| Provider Name | Angela Joy Wood |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1235237439 PECOS PAC ID: 5496751695 Enrollment ID: I20061011000419 |
| Provider Name | Steffen P Christensen Iii |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336167063 PECOS PAC ID: 4587573969 Enrollment ID: I20061108000543 |
| Provider Name | Joy M Quitberg |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477583466 PECOS PAC ID: 2264430099 Enrollment ID: I20061110000058 |
| Provider Name | Kristi A Gagne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245210848 PECOS PAC ID: 4981591856 Enrollment ID: I20070103000420 |
| Provider Name | Michael S Currie |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588743561 PECOS PAC ID: 4183625692 Enrollment ID: I20070126000174 |
| Provider Name | Chad Eugene Boen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215034095 PECOS PAC ID: 9133117443 Enrollment ID: I20070205000622 |
| Provider Name | David J Clardy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063430791 PECOS PAC ID: 3375583511 Enrollment ID: I20070212000453 |
| Provider Name | Erin L Volden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003838590 PECOS PAC ID: 8820004187 Enrollment ID: I20070213000167 |
| Provider Name | Thomas Jarrad Matzke |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1639121304 PECOS PAC ID: 1456304104 Enrollment ID: I20070215000311 |
| Provider Name | Nina C Sjoquist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831110055 PECOS PAC ID: 0648372896 Enrollment ID: I20070219000779 |
| Provider Name | Peggy J Maasjo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508883117 PECOS PAC ID: 4789787581 Enrollment ID: I20070315000413 |
| Provider Name | Joshua Wynne |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376565960 PECOS PAC ID: 6800860479 Enrollment ID: I20070406000179 |
| Provider Name | David A Bailey |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1639197338 PECOS PAC ID: 0547292344 Enrollment ID: I20070427000003 |
| Provider Name | John P Mccarthy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780638064 PECOS PAC ID: 7012975477 Enrollment ID: I20070511000008 |
| Provider Name | Mark A Shanfeld |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1710024435 PECOS PAC ID: 0143250159 Enrollment ID: I20070710000318 |
| Provider Name | Sujatha Roberts |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699899468 PECOS PAC ID: 6608976311 Enrollment ID: I20070711000088 |
| Provider Name | Katherine S Hall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740208396 PECOS PAC ID: 5991774903 Enrollment ID: I20070712000056 |
| Provider Name | Matthew F Sanford |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033167416 PECOS PAC ID: 3173534575 Enrollment ID: I20070719000581 |
| Provider Name | Germaine E Cheslock |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154468890 PECOS PAC ID: 9335240191 Enrollment ID: I20070723000840 |
| Provider Name | Paul Mchenry |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962422923 PECOS PAC ID: 3072590348 Enrollment ID: I20070802000519 |
| Provider Name | Yassar Almanaseer |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1467585349 PECOS PAC ID: 4183658594 Enrollment ID: I20070809000722 |
| Provider Name | James S Wagner |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942234851 PECOS PAC ID: 2769575489 Enrollment ID: I20070911000303 |
| Provider Name | Justin M Horner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326169061 PECOS PAC ID: 3971696618 Enrollment ID: I20070911000471 |
| Provider Name | Pamela M Samson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760403984 PECOS PAC ID: 1153414818 Enrollment ID: I20070911000702 |
| Provider Name | Timothy M Nyarandi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124222351 PECOS PAC ID: 5092808360 Enrollment ID: I20070912000323 |
| Provider Name | Steven J Quamme |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023030665 PECOS PAC ID: 2466546601 Enrollment ID: I20070919000753 |
| Provider Name | William G Muller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942228531 PECOS PAC ID: 5698869733 Enrollment ID: I20070919000772 |
| Provider Name | Maria K Statton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194746313 PECOS PAC ID: 0547367716 Enrollment ID: I20070919000866 |
| Provider Name | Neil A Skogerboe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487685582 PECOS PAC ID: 9032203187 Enrollment ID: I20070919000878 |
| Provider Name | Cheri J Berge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073535662 PECOS PAC ID: 3375574205 Enrollment ID: I20071008000321 |
| Provider Name | Andrew J Stasko |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265516439 PECOS PAC ID: 5597796821 Enrollment ID: I20071011000544 |
| Provider Name | Cheryl K Bauer-olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871553313 PECOS PAC ID: 0547281826 Enrollment ID: I20071106000289 |
| Provider Name | Linda Mt Helgeson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194910505 PECOS PAC ID: 3072603240 Enrollment ID: I20071212000545 |
| Provider Name | Dean A Gross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689697682 PECOS PAC ID: 9739279654 Enrollment ID: I20071217000021 |
| Provider Name | Deborah Lee Gibb-potts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164604492 PECOS PAC ID: 5294815650 Enrollment ID: I20080110000419 |
| Provider Name | Jamey Chase Jessen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982643219 PECOS PAC ID: 5193711208 Enrollment ID: I20080116000520 |
| Provider Name | Stacey Alan Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649210832 PECOS PAC ID: 8729169446 Enrollment ID: I20080118000308 |
| Provider Name | Bruce E Piatt |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972532240 PECOS PAC ID: 7618066283 Enrollment ID: I20080119000007 |
| Provider Name | Heeraimangalore S Manjunath |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1366472441 PECOS PAC ID: 5193782951 Enrollment ID: I20080121000080 |
| Provider Name | James T Langland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699711457 PECOS PAC ID: 3779488754 Enrollment ID: I20080201000031 |
| Provider Name | Bonnie M Bailey |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1831137660 PECOS PAC ID: 6204892524 Enrollment ID: I20080215000563 |
| Provider Name | Susan I Farkas |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275568933 PECOS PAC ID: 5395729677 Enrollment ID: I20080220000692 |
| Provider Name | Grant M Christopher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659398659 PECOS PAC ID: 8527143346 Enrollment ID: I20080304000510 |
| Provider Name | Roland Armstrong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265450969 PECOS PAC ID: 0143122648 Enrollment ID: I20080403000447 |
| Provider Name | Ronica Marie Wahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770760605 PECOS PAC ID: 7517046709 Enrollment ID: I20080429000619 |
| Provider Name | Jennifer A Hoffmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295926145 PECOS PAC ID: 1557376506 Enrollment ID: I20080510000008 |
| Provider Name | Leann A Wages |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1396763983 PECOS PAC ID: 4981610946 Enrollment ID: I20080529000732 |
| Provider Name | Terrance L Johnson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194721290 PECOS PAC ID: 4587735535 Enrollment ID: I20080618000425 |
| Provider Name | Allan S Campbell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609926690 PECOS PAC ID: 2769554278 Enrollment ID: I20080627000432 |
| Provider Name | Kari Jo Borgmann |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285894964 PECOS PAC ID: 7911079959 Enrollment ID: I20080708000256 |
| Provider Name | Brenda K Muckenhirn |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740440429 PECOS PAC ID: 5193897148 Enrollment ID: I20080708000264 |
| Provider Name | Peter Biegler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164683363 PECOS PAC ID: 8325111537 Enrollment ID: I20080722000204 |
| Provider Name | Andrew N Schock |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922260439 PECOS PAC ID: 8123192697 Enrollment ID: I20080731000498 |
| Provider Name | Diane M Pittman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205942158 PECOS PAC ID: 9830132620 Enrollment ID: I20080821000452 |
| Provider Name | Karin Ann Lokensgard Pierce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942425384 PECOS PAC ID: 4688743859 Enrollment ID: I20080904000665 |
| Provider Name | Laurie Straw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467473686 PECOS PAC ID: 2466353982 Enrollment ID: I20080917000859 |
| Provider Name | Michael J Carr |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104844802 PECOS PAC ID: 6901851062 Enrollment ID: I20080925000734 |
| Provider Name | Amber Lyn Szczepanski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073760237 PECOS PAC ID: 3779651559 Enrollment ID: I20081007000177 |
| Provider Name | James E Halvorson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972521524 PECOS PAC ID: 6103994926 Enrollment ID: I20081007000495 |
| Provider Name | Andrew J Johnson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1649281361 PECOS PAC ID: 3779523402 Enrollment ID: I20081104000501 |
| Provider Name | Patrick E Emery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144247008 PECOS PAC ID: 7618037060 Enrollment ID: I20081115000141 |
| Provider Name | William Shuler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649200395 PECOS PAC ID: 5193715373 Enrollment ID: I20081119000729 |
| Provider Name | Erika K Beckett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861649071 PECOS PAC ID: 9638230279 Enrollment ID: I20081202000100 |
| Provider Name | Timothy J Studer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285655407 PECOS PAC ID: 5496816365 Enrollment ID: I20081210000550 |
| Provider Name | Benjamin P Roy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023076064 PECOS PAC ID: 2567523350 Enrollment ID: I20081211000810 |
| Provider Name | Randy J Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235109430 PECOS PAC ID: 6800783770 Enrollment ID: I20081215000183 |
| Provider Name | Douglas Marlin Griffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700856911 PECOS PAC ID: 5799672663 Enrollment ID: I20081215000248 |
| Provider Name | Todd David Reil |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1154355311 PECOS PAC ID: 6103894464 Enrollment ID: I20090106000090 |
| Provider Name | Brian J Gatheridge |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043465644 PECOS PAC ID: 4385707165 Enrollment ID: I20090106000627 |
| Provider Name | Gretchen Bea Rockstad |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1497776611 PECOS PAC ID: 4688730229 Enrollment ID: I20090305000224 |
| Provider Name | Ram Prasad Paneru |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740457902 PECOS PAC ID: 7719043926 Enrollment ID: I20090312000344 |
| Provider Name | Charles J Breen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114944113 PECOS PAC ID: 2668402660 Enrollment ID: I20090313000211 |
| Provider Name | Mohamed Sanaullah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588685705 PECOS PAC ID: 5395647549 Enrollment ID: I20090421000301 |
| Provider Name | Rebecca A Joyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912977133 PECOS PAC ID: 6608924139 Enrollment ID: I20090511000279 |
| Provider Name | Timothy J Luithle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578581146 PECOS PAC ID: 2769533355 Enrollment ID: I20090622000207 |
| Provider Name | Stephen Patrick Garrity |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033137682 PECOS PAC ID: 6901957570 Enrollment ID: I20090623000255 |
| Provider Name | Jason M Asheim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780693424 PECOS PAC ID: 8628077872 Enrollment ID: I20090710000242 |
| Provider Name | Jonathan Ross Fish |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629117890 PECOS PAC ID: 6103979836 Enrollment ID: I20090728000902 |
| Provider Name | Judith A Mills |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477794766 PECOS PAC ID: 3678626272 Enrollment ID: I20090729000738 |
| Provider Name | Kevin A Dahl |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356551089 PECOS PAC ID: 7517010580 Enrollment ID: I20090810000165 |
| Provider Name | Matthew Trefz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376735035 PECOS PAC ID: 9739230590 Enrollment ID: I20090810000398 |
| Provider Name | Allison J Clapp |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366694614 PECOS PAC ID: 2264587369 Enrollment ID: I20090825000519 |
| Provider Name | Augusto Alonto |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1700833845 PECOS PAC ID: 4385607753 Enrollment ID: I20091021000267 |
| Provider Name | Kimberly J Woodland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881825479 PECOS PAC ID: 2769529833 Enrollment ID: I20091021000694 |
| Provider Name | Thomas Paul Haas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821074733 PECOS PAC ID: 5395882294 Enrollment ID: I20091026000650 |
| Provider Name | Chetan P Maingi |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1952408809 PECOS PAC ID: 1254338551 Enrollment ID: I20091223000443 |
| Provider Name | Brenna L Tate |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1164756243 PECOS PAC ID: 4981745015 Enrollment ID: I20100111000612 |
| Provider Name | Thomas M Seaworth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750302972 PECOS PAC ID: 0345377347 Enrollment ID: I20100422001165 |
| Provider Name | Lisa Jo Jamsa Tollefson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962627398 PECOS PAC ID: 4789754870 Enrollment ID: I20100524000554 |
| Provider Name | Zhong S Zhao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821069287 PECOS PAC ID: 0042349813 Enrollment ID: I20100603000901 |
| Provider Name | Mitchell B Goldstein |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497773030 PECOS PAC ID: 4082745922 Enrollment ID: I20100622000128 |
| Provider Name | Anand G Kantak |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1669499331 PECOS PAC ID: 7214098755 Enrollment ID: I20100629000936 |
| Provider Name | Ajay K Bhora |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538184023 PECOS PAC ID: 1759385453 Enrollment ID: I20100708001021 |
| Provider Name | Matthew R Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326278573 PECOS PAC ID: 4082746391 Enrollment ID: I20100722000666 |
| Provider Name | Shaun P Myre |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427379759 PECOS PAC ID: 1052444064 Enrollment ID: I20100728000228 |
| Provider Name | Mandy L Hoie |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689985988 PECOS PAC ID: 0749313252 Enrollment ID: I20100804001015 |
| Provider Name | Jonathon M Aligada |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427388040 PECOS PAC ID: 7315070679 Enrollment ID: I20100806000501 |
| Provider Name | Richard L Stennes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194793919 PECOS PAC ID: 2163555350 Enrollment ID: I20100809001109 |
| Provider Name | Michelle Marie Quale |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1902982481 PECOS PAC ID: 4486778982 Enrollment ID: I20100907000522 |
| Provider Name | Jay J Bauder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972737054 PECOS PAC ID: 1850416975 Enrollment ID: I20100914000037 |
| Provider Name | Bruce J Klosterman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740207414 PECOS PAC ID: 6002834850 Enrollment ID: I20100920000208 |
| Provider Name | Kaye C Mickelson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689637035 PECOS PAC ID: 5294927166 Enrollment ID: I20101011000431 |
| Provider Name | Theodore J Sawchuk |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1629090261 PECOS PAC ID: 2668596446 Enrollment ID: I20101018000535 |
| Provider Name | Mark E Colliton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134147861 PECOS PAC ID: 7517150089 Enrollment ID: I20101018000594 |
| Provider Name | Mark S Claussen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447278171 PECOS PAC ID: 9537101282 Enrollment ID: I20101110001275 |
| Provider Name | Donald J Stallman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386665503 PECOS PAC ID: 4880889880 Enrollment ID: I20101116001132 |
| Provider Name | Sherry S Billups |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124045125 PECOS PAC ID: 2860688769 Enrollment ID: I20101117001475 |
| Provider Name | Julie B Larson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598783169 PECOS PAC ID: 2668668492 Enrollment ID: I20101118001410 |
| Provider Name | Jeffrey L Blickenstaff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225056955 PECOS PAC ID: 1951597053 Enrollment ID: I20101201000974 |
| Provider Name | John W Bollinger |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1255359956 PECOS PAC ID: 0749317998 Enrollment ID: I20101203000241 |
| Provider Name | Carmen Briones |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700965753 PECOS PAC ID: 6305033895 Enrollment ID: I20101209000724 |
| Provider Name | Stephen R Hietala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710905351 PECOS PAC ID: 0941497473 Enrollment ID: I20101209001315 |
| Provider Name | Peggy A Sheldon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104857200 PECOS PAC ID: 7517154784 Enrollment ID: I20101214000758 |
| Provider Name | Natalie S Roholt |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1215958434 PECOS PAC ID: 9234326406 Enrollment ID: I20101214000771 |
| Provider Name | William G Dicks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073535563 PECOS PAC ID: 8729276696 Enrollment ID: I20101218000047 |
| Provider Name | Michael L Sand |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154343705 PECOS PAC ID: 1456543438 Enrollment ID: I20101218000062 |
| Provider Name | David Wilcox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124040712 PECOS PAC ID: 2769539949 Enrollment ID: I20110104001318 |
| Provider Name | Richard C Bailly |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215954201 PECOS PAC ID: 1557555380 Enrollment ID: I20110110000933 |
| Provider Name | Dennis E Bier |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1114945847 PECOS PAC ID: 5193910719 Enrollment ID: I20110111000701 |
| Provider Name | Keith A Nelson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225347792 PECOS PAC ID: 5698964146 Enrollment ID: I20110113001059 |
| Provider Name | Mohamed Hussein |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1639488166 PECOS PAC ID: 8527257096 Enrollment ID: I20110114000043 |
| Provider Name | Heather A Kiebke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144265513 PECOS PAC ID: 7911186044 Enrollment ID: I20110121000468 |
| Provider Name | Mark S Dwyer |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1962420505 PECOS PAC ID: 5698736437 Enrollment ID: I20110124001008 |
| Provider Name | Jeffrey W Watkins |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1053349860 PECOS PAC ID: 8123910452 Enrollment ID: I20110209000535 |
| Provider Name | Lynda R Siepker |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1376636514 PECOS PAC ID: 8628258415 Enrollment ID: I20110210001205 |
| Provider Name | Steven K Anderson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1518991678 PECOS PAC ID: 9032155841 Enrollment ID: I20110224000999 |
| Provider Name | Andrea K Westby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992939177 PECOS PAC ID: 7719169606 Enrollment ID: I20110314001081 |
| Provider Name | Morris Hund |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790703437 PECOS PAC ID: 7113114281 Enrollment ID: I20110321000784 |
| Provider Name | Luis A Garcia |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104844752 PECOS PAC ID: 3971797309 Enrollment ID: I20110328000852 |
| Provider Name | Elizabeth A Evenson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386967263 PECOS PAC ID: 1355526351 Enrollment ID: I20110505000607 |
| Provider Name | Dubert M Guerrero |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811103989 PECOS PAC ID: 1153445598 Enrollment ID: I20110524000626 |
| Provider Name | Richard E Arness |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1902824600 PECOS PAC ID: 1658565171 Enrollment ID: I20110527000445 |
| Provider Name | Yongsheng Ren |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1770510828 PECOS PAC ID: 1850395617 Enrollment ID: I20110622000501 |
| Provider Name | Julie Ann Tobkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972807709 PECOS PAC ID: 9335327014 Enrollment ID: I20110628000606 |
| Provider Name | Christopher G Kallenbach |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649460551 PECOS PAC ID: 3870645492 Enrollment ID: I20110629000721 |
| Provider Name | Mohammad Nurulqadr Jameel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1114071602 PECOS PAC ID: 3375721731 Enrollment ID: I20110707000303 |
| Provider Name | Peter E Friedell |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1356360531 PECOS PAC ID: 4284527359 Enrollment ID: I20110715000218 |
| Provider Name | Susan K Hofland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265453492 PECOS PAC ID: 0042406902 Enrollment ID: I20110719000289 |
| Provider Name | Michael David Segal |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578585121 PECOS PAC ID: 9234319583 Enrollment ID: I20110721000258 |
| Provider Name | Ragna Adair Godtland |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386958452 PECOS PAC ID: 0840489621 Enrollment ID: I20110722000702 |
| Provider Name | Joeanna L Aasen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154617256 PECOS PAC ID: 7810166055 Enrollment ID: I20110804000622 |
| Provider Name | Laurie Jung |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942236815 PECOS PAC ID: 2365441383 Enrollment ID: I20110805000126 |
| Provider Name | Bhargav M Mistry |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033136676 PECOS PAC ID: 5597957407 Enrollment ID: I20110817000426 |
| Provider Name | Paul G Mariani |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1164597480 PECOS PAC ID: 8729058250 Enrollment ID: I20110819000507 |
| Provider Name | Jennifer Ann Fraik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619264942 PECOS PAC ID: 5597935700 Enrollment ID: I20110825000731 |
| Provider Name | Deanna K Skaar |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1982859229 PECOS PAC ID: 2567632425 Enrollment ID: I20110901000010 |
| Provider Name | Michael Craig Thurgood |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265571137 PECOS PAC ID: 3072706183 Enrollment ID: I20110901000203 |
| Provider Name | Jedidiah J Perkerewicz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548469208 PECOS PAC ID: 4688846108 Enrollment ID: I20111005000711 |
| Provider Name | Robert P Ostmo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487686689 PECOS PAC ID: 9032303193 Enrollment ID: I20111011000087 |
| Provider Name | Christel L Parvey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851670707 PECOS PAC ID: 3173796885 Enrollment ID: I20111025000383 |
| Provider Name | Mckenzi K Burmeister |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235456773 PECOS PAC ID: 2860665254 Enrollment ID: I20111031000558 |
| Provider Name | Jeffrey B Andersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184701856 PECOS PAC ID: 8729088042 Enrollment ID: I20111109000729 |
| Provider Name | Gregory L Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699709592 PECOS PAC ID: 2163432451 Enrollment ID: I20111109000809 |
| Provider Name | Marisa Lea Zutter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760786032 PECOS PAC ID: 5496920050 Enrollment ID: I20111208000821 |
| Provider Name | Robert Joseph Olson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518985118 PECOS PAC ID: 4981890829 Enrollment ID: I20111213000729 |
| Provider Name | Susan L Scarberry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023039245 PECOS PAC ID: 4082676044 Enrollment ID: I20120124000694 |
| Provider Name | Jane P Leno |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710255724 PECOS PAC ID: 8426215450 Enrollment ID: I20120202000885 |
| Provider Name | Steven K Glunberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689692220 PECOS PAC ID: 4385695246 Enrollment ID: I20120206000200 |
| Provider Name | Katherine L Friese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821379462 PECOS PAC ID: 9234396664 Enrollment ID: I20120213000594 |
| Provider Name | Anne G Gilbertson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1104108166 PECOS PAC ID: 6507025079 Enrollment ID: I20120302000417 |
| Provider Name | Eric D Wiest |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285898031 PECOS PAC ID: 1850569245 Enrollment ID: I20120314000288 |
| Provider Name | Juan Carlos Belalcazar Canal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750578175 PECOS PAC ID: 4587823117 Enrollment ID: I20120316000561 |
| Provider Name | Mark M Gitau |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1225073661 PECOS PAC ID: 0547391757 Enrollment ID: I20120320000056 |
| Provider Name | Heidi Lynn Saarinen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104123298 PECOS PAC ID: 1759567563 Enrollment ID: I20120406000190 |
| Provider Name | Woei Yeang Gary Eng |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1154513018 PECOS PAC ID: 8729119938 Enrollment ID: I20120612000469 |
| Provider Name | Joellen M Kohlman Petrick |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114985454 PECOS PAC ID: 6103091129 Enrollment ID: I20120614000709 |
| Provider Name | Amy L Ochsendorf |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831346873 PECOS PAC ID: 8527222645 Enrollment ID: I20120620000742 |
| Provider Name | Christopher S Robertson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104128909 PECOS PAC ID: 0941498042 Enrollment ID: I20120809000715 |
| Provider Name | Carolyn C Klehr |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578829032 PECOS PAC ID: 0345497798 Enrollment ID: I20120821000132 |
| Provider Name | Misty M Folkestad |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386888568 PECOS PAC ID: 6507013208 Enrollment ID: I20120831000518 |
| Provider Name | Mateen Ur Rahman |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1669621306 PECOS PAC ID: 4082862644 Enrollment ID: I20120924000755 |
| Provider Name | Ram Prasad Kafle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609003516 PECOS PAC ID: 6800045196 Enrollment ID: I20121002000133 |
| Provider Name | Lorraine A Swan Kremeier |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093736217 PECOS PAC ID: 9739126939 Enrollment ID: I20121206000129 |
| Provider Name | Kenneth Wayne Crabb |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023054681 PECOS PAC ID: 5092865535 Enrollment ID: I20121210000315 |
| Provider Name | Julie Ann Blehm |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760409767 PECOS PAC ID: 8325054687 Enrollment ID: I20130311000354 |
| Provider Name | Matthew J Tinguely |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1548348410 PECOS PAC ID: 2466552815 Enrollment ID: I20130408000160 |
| Provider Name | Spring Anne Huffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700836673 PECOS PAC ID: 0345294401 Enrollment ID: I20130411000129 |
| Provider Name | James E Stevenson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417286683 PECOS PAC ID: 9436294824 Enrollment ID: I20130412000489 |
| Provider Name | Jon D Dangerfield |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245258896 PECOS PAC ID: 2860686904 Enrollment ID: I20130417000134 |
| Provider Name | Nicole M Cullen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114257656 PECOS PAC ID: 4789834854 Enrollment ID: I20130429000513 |
| Provider Name | Susan K Cariveau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023115805 PECOS PAC ID: 1951370543 Enrollment ID: I20130507000500 |
| Provider Name | Kevin M Faber |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1720095482 PECOS PAC ID: 2466459375 Enrollment ID: I20130529000575 |
| Provider Name | Gina Marie Hansen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376852459 PECOS PAC ID: 7315187994 Enrollment ID: I20130702000225 |
| Provider Name | Sandra J Krier |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1629044680 PECOS PAC ID: 8729059928 Enrollment ID: I20130705000425 |
| Provider Name | Mary Jane Richter |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1508109661 PECOS PAC ID: 3678713013 Enrollment ID: I20130709000395 |
| Provider Name | Kenneth Charles Weimer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174624761 PECOS PAC ID: 1557435484 Enrollment ID: I20130719000155 |
| Provider Name | Jagan Mohan Rao Jakkula |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891924957 PECOS PAC ID: 5193966729 Enrollment ID: I20130724000842 |
| Provider Name | Samar Malaeb |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1326216037 PECOS PAC ID: 8022250596 Enrollment ID: I20130813000312 |
| Provider Name | Kashif A Zuberi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508919572 PECOS PAC ID: 9739339466 Enrollment ID: I20130815000741 |
| Provider Name | James Daniel Dewar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1013128222 PECOS PAC ID: 1355412917 Enrollment ID: I20130820000154 |
| Provider Name | Nicole Marie Cox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639475940 PECOS PAC ID: 0244464857 Enrollment ID: I20131015001547 |
| Provider Name | Mary K Holm |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477583664 PECOS PAC ID: 0446349153 Enrollment ID: I20131018000413 |
| Provider Name | Romie M Tinsay |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750312708 PECOS PAC ID: 7517192719 Enrollment ID: I20131024000122 |
| Provider Name | Luis Casas |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1679541841 PECOS PAC ID: 5597796938 Enrollment ID: I20131107001553 |
| Provider Name | Alissa Jo Hoban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861830275 PECOS PAC ID: 0244474823 Enrollment ID: I20131114001111 |
| Provider Name | Samantha Lynn Beauchman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922387950 PECOS PAC ID: 5092941906 Enrollment ID: I20131125001449 |
| Provider Name | Chris L Cleveland |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1982693875 PECOS PAC ID: 6901052471 Enrollment ID: I20131203000026 |
| Provider Name | Leah M Hochstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457799652 PECOS PAC ID: 5799926838 Enrollment ID: I20131203000065 |
| Provider Name | Stephen J Rith Najarian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306955521 PECOS PAC ID: 7810189115 Enrollment ID: I20131205000375 |
| Provider Name | Joshua Paul Klabunde |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235563917 PECOS PAC ID: 3678700655 Enrollment ID: I20131219000209 |
| Provider Name | Robyn Maley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609205988 PECOS PAC ID: 6800023599 Enrollment ID: I20131231000638 |
| Provider Name | Eric R Promersberger |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1669490264 PECOS PAC ID: 7012101892 Enrollment ID: I20140109001337 |
| Provider Name | Roxanne Marie Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457303000 PECOS PAC ID: 0648174656 Enrollment ID: I20140109001604 |
| Provider Name | Joshua Luther Eken |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275852907 PECOS PAC ID: 8527200120 Enrollment ID: I20140227000982 |
| Provider Name | Adam Wesley Jackson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1881801694 PECOS PAC ID: 0244481042 Enrollment ID: I20140306000675 |
| Provider Name | Nathalie Jean |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700134293 PECOS PAC ID: 2264663186 Enrollment ID: I20140320000269 |
| Provider Name | Kari J Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356770036 PECOS PAC ID: 9335376482 Enrollment ID: I20140422000348 |
| Provider Name | Winter M Ackerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467614503 PECOS PAC ID: 8123202694 Enrollment ID: I20140424000263 |
| Provider Name | Zhanyong Bing |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1023051810 PECOS PAC ID: 6002858453 Enrollment ID: I20140604001150 |
| Provider Name | Stephanie M Hanson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548227846 PECOS PAC ID: 7810061942 Enrollment ID: I20140611001318 |
| Provider Name | Rebecca S Preussler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497776736 PECOS PAC ID: 6406893684 Enrollment ID: I20140611001540 |
| Provider Name | Melissa A Kunkel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336334606 PECOS PAC ID: 9436320793 Enrollment ID: I20140613000500 |
| Provider Name | Alex Jaymes Thompson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639518442 PECOS PAC ID: 0941441992 Enrollment ID: I20140804002484 |
| Provider Name | Joyoti Saha |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851624944 PECOS PAC ID: 6608042809 Enrollment ID: I20140818001281 |
| Provider Name | Samantha J Perleberg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083992002 PECOS PAC ID: 8628291366 Enrollment ID: I20140918000750 |
| Provider Name | Donald R Gullicks |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619288602 PECOS PAC ID: 4183851041 Enrollment ID: I20140929000960 |
| Provider Name | James G Kappenman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235369604 PECOS PAC ID: 2769626670 Enrollment ID: I20140929001413 |
| Provider Name | Brennan M Forward |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659663557 PECOS PAC ID: 5092936096 Enrollment ID: I20141016000011 |
| Provider Name | Pamela Skon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912325713 PECOS PAC ID: 8820210727 Enrollment ID: I20141110000222 |
| Provider Name | Maria Caroline Bell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174529929 PECOS PAC ID: 0941102024 Enrollment ID: I20141125000063 |
| Provider Name | Rebekah J Aakre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134538911 PECOS PAC ID: 8022237148 Enrollment ID: I20141213000255 |
| Provider Name | Eram Shahira |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1578762548 PECOS PAC ID: 1052403672 Enrollment ID: I20150127001824 |
| Provider Name | Darin Lang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780602342 PECOS PAC ID: 2769414655 Enrollment ID: I20150210001993 |
| Provider Name | Kruti J Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043574262 PECOS PAC ID: 7012232218 Enrollment ID: I20150210002426 |
| Provider Name | Prabha Nanjundamurthy Dakshayini |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265842199 PECOS PAC ID: 9931425428 Enrollment ID: I20150227000427 |
| Provider Name | Alisha A Husfeldt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669765905 PECOS PAC ID: 6507019122 Enrollment ID: I20150227000970 |
| Provider Name | John J Loffarelli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194728329 PECOS PAC ID: 5890770259 Enrollment ID: I20150304001695 |
| Provider Name | David A Riley |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1649245838 PECOS PAC ID: 5698899094 Enrollment ID: I20150325000907 |
| Provider Name | Mohammad Sarraf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851447528 PECOS PAC ID: 5496817983 Enrollment ID: I20150401001739 |
| Provider Name | Victor M Rostapshov |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1548315435 PECOS PAC ID: 9638239627 Enrollment ID: I20150409000770 |
| Provider Name | Vijay Jayanti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003112657 PECOS PAC ID: 4688828742 Enrollment ID: I20150518002078 |
| Provider Name | Roger M Macklis |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1457315103 PECOS PAC ID: 3476552266 Enrollment ID: I20150604001828 |
| Provider Name | Anders K Osthus |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043654643 PECOS PAC ID: 7416269642 Enrollment ID: I20150701000790 |
| Provider Name | Lucas K Genereux |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346592680 PECOS PAC ID: 0547572661 Enrollment ID: I20150702000859 |
| Provider Name | Ravinda Samaraweera |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053573287 PECOS PAC ID: 5294960860 Enrollment ID: I20150714002906 |
| Provider Name | Vijay Neelamegam Premnath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285834614 PECOS PAC ID: 0648443283 Enrollment ID: I20150717000698 |
| Provider Name | Tabrez Sheriff Ameerjan Nayaz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467700930 PECOS PAC ID: 9830402460 Enrollment ID: I20150724011298 |
| Provider Name | Jonathan C Olivas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942599048 PECOS PAC ID: 5698918977 Enrollment ID: I20150730011153 |
| Provider Name | Micah Richard Treuer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285994517 PECOS PAC ID: 0648584870 Enrollment ID: I20150803000005 |
| Provider Name | Geeta Bai Khanwani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821343112 PECOS PAC ID: 5193039170 Enrollment ID: I20150804005623 |
| Provider Name | Shahid Nafees Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205182284 PECOS PAC ID: 5991019705 Enrollment ID: I20150806010236 |
| Provider Name | Emily Kalina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942683990 PECOS PAC ID: 9537473251 Enrollment ID: I20150807014605 |
| Provider Name | Eric Swensen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679669139 PECOS PAC ID: 6800877796 Enrollment ID: I20150810001677 |
| Provider Name | Anne Georgina Cushing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265475305 PECOS PAC ID: 3072578939 Enrollment ID: I20150810001898 |
| Provider Name | Danial S Sturgill |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992859664 PECOS PAC ID: 7113043340 Enrollment ID: I20150811006134 |
| Provider Name | Kristine E Martens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477867943 PECOS PAC ID: 6507000247 Enrollment ID: I20150812009145 |
| Provider Name | Richard Moser |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689606873 PECOS PAC ID: 0547455982 Enrollment ID: I20150813012492 |
| Provider Name | Mary Ann B Donaldson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417974379 PECOS PAC ID: 9133317613 Enrollment ID: I20150814012645 |
| Provider Name | Lindsey Marie Sloan Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699102897 PECOS PAC ID: 2860620929 Enrollment ID: I20150814014811 |
| Provider Name | Kjerstin Helweg |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1134505050 PECOS PAC ID: 3971818865 Enrollment ID: I20150821012893 |
| Provider Name | Cindy Sondag |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598050189 PECOS PAC ID: 5799904926 Enrollment ID: I20150821014843 |
| Provider Name | Ashley M Lundin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1457649048 PECOS PAC ID: 4587887419 Enrollment ID: I20150825004218 |
| Provider Name | Eric David Hyun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831450170 PECOS PAC ID: 8527374388 Enrollment ID: I20150825004478 |
| Provider Name | John Tinjum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093953366 PECOS PAC ID: 3173846086 Enrollment ID: I20150825004985 |
| Provider Name | Brian J Hamm |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952542995 PECOS PAC ID: 4981919016 Enrollment ID: I20150826002265 |
| Provider Name | Brett Jon Glawe |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548589054 PECOS PAC ID: 9133367501 Enrollment ID: I20150827003288 |
| Provider Name | Manit Singla |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356605968 PECOS PAC ID: 7113233255 Enrollment ID: I20150903001230 |
| Provider Name | Sarah B Erickson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659756328 PECOS PAC ID: 1456668227 Enrollment ID: I20150911001577 |
| Provider Name | Matthew J Nielsen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235442575 PECOS PAC ID: 0547577751 Enrollment ID: I20150921003276 |
| Provider Name | Philip Pc Heuer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326414475 PECOS PAC ID: 8123266657 Enrollment ID: I20150922002001 |
| Provider Name | Amy Joy Bro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114314093 PECOS PAC ID: 8123336708 Enrollment ID: I20150930003296 |
| Provider Name | Casey B Hovendick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639548795 PECOS PAC ID: 8022327428 Enrollment ID: I20151027000134 |
| Provider Name | Lorant Divald |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275859670 PECOS PAC ID: 7719111020 Enrollment ID: I20151027000535 |
| Provider Name | Laura Nyhus |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1730271958 PECOS PAC ID: 6901116086 Enrollment ID: I20151102000555 |
| Provider Name | Stephanie Jean Corneliussen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255605762 PECOS PAC ID: 8628234192 Enrollment ID: I20151103001114 |
| Provider Name | Brianna J Crawford |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285005991 PECOS PAC ID: 8729398276 Enrollment ID: I20151112001430 |
| Provider Name | Molissa M Hager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780903047 PECOS PAC ID: 9436283991 Enrollment ID: I20151120001280 |
| Provider Name | Nils-erik J Juanto Laver |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306274600 PECOS PAC ID: 3476772708 Enrollment ID: I20151202000114 |
| Provider Name | Scott A Engum |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194705806 PECOS PAC ID: 9133133572 Enrollment ID: I20151228001488 |
| Provider Name | Michelle L Resler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619003381 PECOS PAC ID: 7416038021 Enrollment ID: I20160106001696 |
| Provider Name | Mariah D Laver Juanto |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629401567 PECOS PAC ID: 5294953352 Enrollment ID: I20160209001962 |
| Provider Name | Amanda J Storey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336508274 PECOS PAC ID: 1951609932 Enrollment ID: I20160407001320 |
| Provider Name | Jon C Ulven |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114948452 PECOS PAC ID: 1456342161 Enrollment ID: I20160412002147 |
| Provider Name | Megan C Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245602119 PECOS PAC ID: 0244538924 Enrollment ID: I20160413000725 |
| Provider Name | Jau-shin Lou |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669489597 PECOS PAC ID: 4183785017 Enrollment ID: I20160413000993 |
| Provider Name | Kenneth J Stone |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992739262 PECOS PAC ID: 8729081427 Enrollment ID: I20160413002375 |
| Provider Name | Abby L Wetterling |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1124411780 PECOS PAC ID: 5294055075 Enrollment ID: I20160506000113 |
| Provider Name | Lakshmanan Ganapathy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023077203 PECOS PAC ID: 1456383694 Enrollment ID: I20160706000023 |
| Provider Name | Amanda R Dahl |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588043863 PECOS PAC ID: 6800103532 Enrollment ID: I20160824001705 |
| Provider Name | Maggie Solien Hartmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710330832 PECOS PAC ID: 1850686841 Enrollment ID: I20160830002101 |
| Provider Name | Breann E Neiger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184902330 PECOS PAC ID: 6305133927 Enrollment ID: I20160926002166 |
| Provider Name | Steven S Swancoat |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215352125 PECOS PAC ID: 5294023586 Enrollment ID: I20161020000206 |
| Provider Name | Tiffany Ann Doyle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023370061 PECOS PAC ID: 8628385713 Enrollment ID: I20161222000607 |
| Provider Name | Cheryl Ellen Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558813048 PECOS PAC ID: 8527348499 Enrollment ID: I20161222001630 |
| Provider Name | Samy M Heshmat |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1124218664 PECOS PAC ID: 9234370354 Enrollment ID: I20170316002134 |
| Provider Name | Joel H Blanchard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356368021 PECOS PAC ID: 2365449311 Enrollment ID: I20170420000933 |
| Provider Name | Vanessa D Gil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073955043 PECOS PAC ID: 2365751161 Enrollment ID: I20170425001186 |
| Provider Name | Ashley A Woitzel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184972275 PECOS PAC ID: 2466604368 Enrollment ID: I20170425003053 |
| Provider Name | Jenny L Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538699566 PECOS PAC ID: 3476824863 Enrollment ID: I20170803000341 |
| Provider Name | Ann J Liljegren |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1942738596 PECOS PAC ID: 0244502243 Enrollment ID: I20170825002777 |
| Provider Name | Molly M Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538513155 PECOS PAC ID: 6406136431 Enrollment ID: I20170911000943 |
| Provider Name | Kaylee Miller |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1215342068 PECOS PAC ID: 2668745613 Enrollment ID: I20170913001960 |
| Provider Name | Mary T Barrett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902983976 PECOS PAC ID: 6002901873 Enrollment ID: I20170914003753 |
| Provider Name | Laura M Nichols |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831465269 PECOS PAC ID: 1355659764 Enrollment ID: I20170918001600 |
| Provider Name | Laurie A Chittum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366892689 PECOS PAC ID: 4082901459 Enrollment ID: I20170918003826 |
| Provider Name | Carrie L Holt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518488071 PECOS PAC ID: 5092089169 Enrollment ID: I20170928001261 |
| Provider Name | Natalie F Dvorak |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760801187 PECOS PAC ID: 6204101181 Enrollment ID: I20171003004578 |
| Provider Name | Kyra Decker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093134462 PECOS PAC ID: 4587889928 Enrollment ID: I20180103001426 |
| Provider Name | Ellen D Vogels |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417255191 PECOS PAC ID: 1850696105 Enrollment ID: I20180108002546 |
| Provider Name | Rekha Kallamadi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437483823 PECOS PAC ID: 3072769215 Enrollment ID: I20180124002638 |
| Provider Name | Callie Greene |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871005843 PECOS PAC ID: 8224398680 Enrollment ID: I20180202000025 |
| Provider Name | Amanda Carol Houghtaling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770090094 PECOS PAC ID: 4789945908 Enrollment ID: I20180305002002 |
| Provider Name | Kerry A Stevens |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891934311 PECOS PAC ID: 1153472048 Enrollment ID: I20180816000015 |
| Provider Name | Peter Van Eerden |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851397509 PECOS PAC ID: 6901894849 Enrollment ID: I20181003002281 |
| Provider Name | Sugong Chen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487972972 PECOS PAC ID: 9436388220 Enrollment ID: I20181102000750 |
| Provider Name | Tina Mcdonald |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740683796 PECOS PAC ID: 8729331996 Enrollment ID: I20181106000453 |
| Provider Name | Elizabeth M Engum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649755166 PECOS PAC ID: 3971857665 Enrollment ID: I20181115002077 |
| Provider Name | Amy J Cross |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1356524029 PECOS PAC ID: 1557605805 Enrollment ID: I20181128000367 |
| Provider Name | Ashley Ruesink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730535386 PECOS PAC ID: 5890088769 Enrollment ID: I20181210000250 |
| Provider Name | Tamera A Ostenaa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013483692 PECOS PAC ID: 3274878319 Enrollment ID: I20181218003943 |
| Provider Name | Heather P Morrisette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568941110 PECOS PAC ID: 0244576544 Enrollment ID: I20190108000917 |
| Provider Name | Allison L Hetland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336412352 PECOS PAC ID: 9537387576 Enrollment ID: I20190401000620 |
| Provider Name | Tawnia A Netland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477702645 PECOS PAC ID: 1951642651 Enrollment ID: I20190405002247 |
| Provider Name | Todd D Sekundiak |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780634568 PECOS PAC ID: 7719901982 Enrollment ID: I20190408001505 |
| Provider Name | Daniel T Fox |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073568648 PECOS PAC ID: 6406758796 Enrollment ID: I20190425002113 |
| Provider Name | Rachel Kvasager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134468192 PECOS PAC ID: 1456598499 Enrollment ID: I20190710002485 |
| Provider Name | Yu Ting Wung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376925958 PECOS PAC ID: 7012244890 Enrollment ID: I20190816001848 |
| Provider Name | Ann L Breen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285298240 PECOS PAC ID: 3870821358 Enrollment ID: I20190821003093 |
| Provider Name | Sheri Lou Krogstad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134129042 PECOS PAC ID: 4688640311 Enrollment ID: I20190824000503 |
| Provider Name | Jessica M Smolen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003477894 PECOS PAC ID: 4486984093 Enrollment ID: I20190925000598 |
| Provider Name | Rebecca A Schulz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881247575 PECOS PAC ID: 0547590721 Enrollment ID: I20191002000073 |
| Provider Name | Dana M Eaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902458383 PECOS PAC ID: 6002147683 Enrollment ID: I20191011002409 |
| Provider Name | Samuel M Hintz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790191435 PECOS PAC ID: 2567794647 Enrollment ID: I20191022001864 |
| Provider Name | Marquitta C Trimnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376190793 PECOS PAC ID: 8729310636 Enrollment ID: I20191025002028 |
| Provider Name | Melissa A Shigematsu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275083685 PECOS PAC ID: 4688938772 Enrollment ID: I20191030003292 |
| Provider Name | Alexis M Tyce |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841849320 PECOS PAC ID: 1052744224 Enrollment ID: I20191202000146 |
| Provider Name | Keith Donohue |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497390298 PECOS PAC ID: 2163859679 Enrollment ID: I20200224000269 |
| Provider Name | Rebecca D Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225662695 PECOS PAC ID: 7416386420 Enrollment ID: I20200326001089 |
| Provider Name | Amber N Mutalipassi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417316001 PECOS PAC ID: 5890117089 Enrollment ID: I20200616002640 |
| Provider Name | Mallory Skorheim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396194031 PECOS PAC ID: 6002242542 Enrollment ID: I20200701000040 |
| Provider Name | Nicole Marie Welsch |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1184642738 PECOS PAC ID: 3072676626 Enrollment ID: I20200730000291 |
| Provider Name | Carole Y Halone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144323700 PECOS PAC ID: 7719089457 Enrollment ID: I20200803001569 |
| Provider Name | Lance James Doeden |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1952659773 PECOS PAC ID: 0446482541 Enrollment ID: I20200824000913 |
| Provider Name | Tammy C Branden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730462631 PECOS PAC ID: 8426475476 Enrollment ID: I20200904001461 |
| Provider Name | Melisha Ann Vannett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740789726 PECOS PAC ID: 8527320803 Enrollment ID: I20200908002749 |
| Provider Name | Benjamin L Dahl |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558565762 PECOS PAC ID: 1850583519 Enrollment ID: I20200928000336 |
| Provider Name | Rachel Irene Kloehn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558989830 PECOS PAC ID: 5698194470 Enrollment ID: I20200928002440 |
| Provider Name | Daniel Wallace Dahl |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285884767 PECOS PAC ID: 8921271164 Enrollment ID: I20201009000200 |
| Provider Name | Dustin Czapiewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447772470 PECOS PAC ID: 4587938808 Enrollment ID: I20201012001554 |
| Provider Name | Max D Disse |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1073975462 PECOS PAC ID: 9830481886 Enrollment ID: I20201019001518 |
| Provider Name | Brady Lee Junes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760911101 PECOS PAC ID: 9436423324 Enrollment ID: I20201104000514 |
| Provider Name | Grant Phillip Haugen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285298349 PECOS PAC ID: 0244640084 Enrollment ID: I20201105000717 |
| Provider Name | Megan Week |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386164358 PECOS PAC ID: 2365853561 Enrollment ID: I20201119000277 |
| Provider Name | David Saxon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689607418 PECOS PAC ID: 6800843848 Enrollment ID: I20201221001542 |
| Provider Name | Samir Golos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326655689 PECOS PAC ID: 8628481934 Enrollment ID: I20210121001688 |
| Provider Name | Toni Sturman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134678675 PECOS PAC ID: 8527347020 Enrollment ID: I20210608002304 |
| Provider Name | Steven Roseno |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376070581 PECOS PAC ID: 1759651052 Enrollment ID: I20210813001317 |
| Provider Name | Mayuresh Rajaratnam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487184255 PECOS PAC ID: 5496028755 Enrollment ID: I20211007000320 |
| Provider Name | Puneet Sharma |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1184808354 PECOS PAC ID: 6507012119 Enrollment ID: I20211008002802 |
| Provider Name | Robert J Steininger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063968121 PECOS PAC ID: 9436408408 Enrollment ID: I20211026001045 |
| Provider Name | Hailey Marie Euerle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831712660 PECOS PAC ID: 5597156695 Enrollment ID: I20211228001640 |
| Provider Name | Jerome Guanciale |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851355366 PECOS PAC ID: 5395705438 Enrollment ID: I20220324002290 |
| Provider Name | Lindsey Marie Ebertowski |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1376022889 PECOS PAC ID: 4385031376 Enrollment ID: I20220421000711 |
| Provider Name | Victoria F Huseby |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1700343076 PECOS PAC ID: 6002156114 Enrollment ID: I20220705002831 |
| Provider Name | Katelyn Hlucny |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1932866191 PECOS PAC ID: 4183005309 Enrollment ID: I20220720002823 |
| Provider Name | Serena Jo Madden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184399396 PECOS PAC ID: 2365825098 Enrollment ID: I20220812003058 |
| Provider Name | Shayne M Spokely |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841693579 PECOS PAC ID: 5799178067 Enrollment ID: I20220906001917 |
| Provider Name | Courtney M Suppa |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154090462 PECOS PAC ID: 5597150078 Enrollment ID: I20221003000734 |
| Provider Name | Danielle Beyer-langerud |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477200426 PECOS PAC ID: 5193104651 Enrollment ID: I20221128000258 |
| Provider Name | Taressa Lynn Strand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659097731 PECOS PAC ID: 5890164727 Enrollment ID: I20221215000156 |
| Provider Name | Joshua Jacob Fisher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700431756 PECOS PAC ID: 8729458435 Enrollment ID: I20221221000429 |
| Provider Name | Taylor Marie Vasek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538806146 PECOS PAC ID: 5698145704 Enrollment ID: I20230106000982 |
| Provider Name | Trey Lyngaas |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295453439 PECOS PAC ID: 2769853613 Enrollment ID: I20230201000199 |
| Provider Name | Utkucan Acar |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1609397421 PECOS PAC ID: 0345676755 Enrollment ID: I20230307001422 |
Well And Company Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1103 Broadway St Ste 102, Alexandria, MN 56308 Phone: 320-314-3828 | |
Thrifty White Drug Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 503 3rd Ave E, Suite 100, Alexandria, MN 56308 Phone: 320-762-1534 Fax: 320-763-7582 | |
Alexandria Industries Family Health & Wellness Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 690 Voyager Dr, Suite 8, Alexandria, MN 56308 Phone: 320-335-2833 Fax: 320-335-2469 | |
Woodland Dentistry Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1301 Hawthorne St, Alexandria, MN 56308 Phone: 320-762-0279 | |
Skill Builderz Pediatric Therapy, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4133 Iowa St Ste 210, Alexandria, MN 56308 Phone: 701-330-8009 | |
Midway Medical Clinic Steven P. Radjenovich D.o. Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 30th Ave W, Alexandria, MN 56308 Phone: 320-763-6452 Fax: 320-763-2971 | |
Cardinal Chiropractic Of Alexandria Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 460 Northside Dr Ne Ste 10, Alexandria, MN 56308 Phone: 320-762-9000 |