CASSANDRA L ETHERIDGE (NPI# 1023648235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023648235 |
Entity Type | Individual |
Full Name | CASSANDRA L ETHERIDGE |
Credential | PA-C |
Practice Address |
5200 Fairview Blvd Wyoming MN 55092-8013 |
Mailing Address |
9036 Lexington Ave N Lowr Unit Circle Pines MN 55014-3623 |
Practice Telephone | 6082147055 |
Mailing Telephone | 6082147055 |
Enumeration Date | 2020-01-16 |
Last Update Date | 2020-01-16 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | 13229 | MN | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
5200 FAIRVIEW BLVD |
City | WYOMING |
State | MN |
Zip Code | 55092-8013 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528061371 | Gunnar Jon Erickson | Ophthalmology | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2005-05-24 |
1902414378 | Fairview Express Care | General Practice | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2020-07-21 |
1023652211 | Natasha Lackas | Speech-Language Pathologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-10-31 |
1467019414 | Terrence Ellis | Clinical Exercise Physiologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-05-24 |
1790341493 | Krystal Kraemer | Dietitian, Registered | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-05-17 |
1225509037 | Lauren Downie | Dietitian, Registered | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-12-06 |
1861977787 | Magdalen Rene Gadbois | Speech-Language Pathologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-09-26 |
1285110338 | Marie Hudalla | Physical Therapist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-07-12 |
1023502697 | Molly Levy | Nurse Practitioner | 5200 Fairview Blvd, Wyoming, MN 55092 | 2018-06-18 |
1982118642 | Meghan Wellmann | Speech-Language Pathologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2017-11-16 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821696022 | Wyoming Family Dental | Dentist | 5378 East Viking Blvd., Wyoming, MN 55092 | 2020-10-12 |
1851909436 | Matthew Rohlf | Dentist | 5378 E Viking Blvd, Wyoming, MN 55092 | 2020-07-20 |
1669013280 | Christina Marie Orde | Technician | 4855 261st Street, Wyoming, MN 55092 | 2019-10-04 |
1609425966 | Faith Bouttell | Technician | 25423 Heims Lake Circle, Wyoming, MN 55092 | 2019-09-10 |
1275875031 | Fairview Express Care | Clinic/Center | 5130 Fairview Blvd, Suite 101, Wyoming, MN 55092 | 2013-03-20 |
1023385242 | St. Croix Orthopaedics, P.a. | Durable Medical Equipment & Medical Supplies | 5200 Fairview Blvd., Wyoming, MN 55092 | 2011-11-17 |
1902851876 | Tamara Piroska Petrac-halatsis | Obstetrics & Gynecology | 5200 Fairview Boulevard, Ob/gyn Department, Wyoming, MN 55092 | 2006-05-22 |
1376922070 | Carli Lynn Ceder | Physical Therapist | 5130 Fairview Blvd, Wyoming, MN 55092 | 2015-05-27 |
1396087433 | Fairview Health Services | Durable Medical Equipment & Medical Supplies | 5130 Fairview Blvd, Suite 104, Wyoming, MN 55092 | 2013-03-26 |
1598007726 | Fairview Health Services | Prosthetic/Orthotic Supplier | 5130 Fairview Blvd, Suite 103, Wyoming, MN 55092 | 2013-03-26 |
Find all providers in zip 55092 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427686534 | Mason L Hutchens | Physician Assistant | 4246 Stonebridge Dr Sw Apt 8, Wyoming, MI 49519-5225 | 2020-04-01 |
1285841841 | Rebecca Anne Hull | Physician Assistant | 2215 44th St Sw, Wyoming, MI 49509-4950 | 2007-05-16 |
1609930262 | Jennifer Lynne Swinburne | Physician Assistant | 2221 Health Drive Sw, Suite 2100, Wyoming, MI 49519-9606 | 2006-12-20 |
1548377708 | Laura Kooy | Physician Assistant | 585 36th St Sw, Wyoming, MI 49509-4002 | 2006-08-24 |
1750498721 | Larry Arnold Brewer | Physician Assistant | 2929 Burlingame S.w., Wyoming, MI 49519 | 2006-08-24 |
1922025725 | Elizabeth A Sayers | Physician Assistant | 2122 Health Dr Sw Ste 133, Wyoming, MI 49519-9698 | 2006-07-16 |
1720046626 | Sherrill D Busboom | Physician Assistant | 2093 Health Dr Sw Ste 100, Wyoming, MI 49519 | 2006-05-02 |
1013524404 | Payton Marsh | Physician Assistant | 2060 Health Dr Sw, Wyoming, MI 49519-9687 | 2020-09-29 |
1881223642 | Allison Donth | Physician Assistant | 5838 Metro Way Sw, Wyoming, MI 49519-9619 | 2020-04-03 |
1235790353 | Amanda Wolterink | Physician Assistant | 5838 Metro Way Sw, Wyoming, MI 49519-9619 | 2019-06-28 |
Find all providers in WYOMING |
Please comment or provide details below to improve the information on CASSANDRA L ETHERIDGE.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.