| Twin Ports Health Solutions Sc | |
|
1728 Tower Ave Superior WI 54880-2543 | |
| (715) 395-0928 | |
| Not Available |
| Full Name | Twin Ports Health Solutions Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 1728 Tower Ave, Superior, Wisconsin |
| Authorized Official Name and Position | James Hoeffling (OWNER, AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7153950928 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Twin Ports Health Solutions Sc 1728 Tower Ave Superior WI 54880-2543 Ph: (715) 395-0928 | Twin Ports Health Solutions Sc 1728 Tower Ave Superior WI 54880-2543 Ph: (715) 395-0928 |
| NPI Number | 1306486592 |
|---|---|
| Provider Enumeration Date | 01/15/2020 |
| Last Update Date | 01/15/2020 |
| Medicare PECOS PAC ID | 6305273699 |
|---|---|
| Medicare Enrollment ID | O20200226001650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306486592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jennifer Deming |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275521700 PECOS PAC ID: 1355243692 Enrollment ID: I20200226001755 |
| Provider Name | Lori Ann Pykkonen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881759629 PECOS PAC ID: 3779673280 Enrollment ID: I20200228001173 |
| Provider Name | Melissa A Burgess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497239800 PECOS PAC ID: 6103161468 Enrollment ID: I20210805001651 |
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