JAKIANN MARIE MORK (NPI# 1184855587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184855587 |
| Entity Type | Individual |
| Full Name | JAKIANN MARIE MORK |
| Credential | ANP-BC |
| Practice Address |
5200 Fairview Blvd Wyoming MN 55092-8013 |
| Mailing Address |
4535 Heights Dr Columbia Heights MN 55421-3321 |
| Practice Telephone | 6519827893 |
| Mailing Telephone | 7635718105 |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2009-08-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
R103401-7 | 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 |
| 1023648235 | Cassandra L Etheridge | Physician Assistant | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2020-01-16 |
| 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 |
| 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 | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093111734 | Nichole L Accetta | Nurse Practitioner | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2014-11-07 |
| 1750669636 | Caroline Westover Angus | Nurse Practitioner | 2122 Health Dr Sw, Wyoming, MI 49519-9698 | 2011-07-27 |
| 1700046828 | Sarah M Schafer | Nurse Practitioner | 6 Main Street, 243, Wyoming, NY 14591-0243 | 2008-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639731821 | Thomas Bieniek | Nurse Practitioner | 1900 Centracare Cir Ste 1600, Saint Cloud, MN 56303-5000 | 2019-07-08 |
| 1649830225 | Kimberly Dawn Hanson | Nurse Practitioner | 1884 Randolph Ave, Saint Paul, MN 55105-1747 | 2019-06-17 |
| 1942762828 | Jodi Lynn Martin | Nurse Practitioner | 720 Washington Ave Se Ste 300, Minneapolis, MN 55414-2904 | 2019-04-01 |
| 1831661123 | Sheryl Jo Rudolf | Nurse Practitioner | 705 Pleasant Avenue, Park Rapids, MN 56470-1440 | 2018-12-26 |
| 1043730310 | Alexis Oluwasheun Bakare | Nurse Practitioner | 1101 Paul Pkwy Ne Apt 215, Blaine, MN 55434-3977 | 2017-06-27 |
| 1528500360 | Judy Pauletich | Nurse Practitioner | 1255 Mayhill Rd N, Maplewood, MN 55119-7158 | 2016-11-10 |
| 1437506417 | Zahra Roble | Nurse Practitioner | 1801 Nicolllet Ave S, Minneapolis, MN 55403 | 2016-05-19 |
| 1932569035 | David Makonde Ogato | Nurse Practitioner | 5325 W 74th St, Edina, MN 55439-2231 | 2016-03-02 |
| 1164896379 | Brooke Johnson | Nurse Practitioner | 12700 Whitewater Dr, Minnetonka, MN 55343-9438 | 2015-11-25 |
| 1962879916 | Carrie Rose Lucio | Nurse Practitioner | 807 Albert St N, Saint Paul, MN 55104-1302 | 2015-08-25 |
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| 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.