ANDREW PETERSEN (NPI# 1316346307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316346307 |
| Entity Type | Individual |
| Full Name | ANDREW PETERSEN |
| Credential | PA-C |
| Practice Address |
1025 Marsh St Mankato MN 56001 |
| Mailing Address |
1025 Marsh St Mankato MN 56001-4752 |
| Practice Telephone | 5076254031 |
| Mailing Telephone | 5076254031 |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2020-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 11969 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 074607 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 700 E University Ave, Des Moines, IA 503162302 | 5152635120 | 5152635164 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629551395 | Andrew Petersen | Physical Therapy Assistant | 5204 W. Colonial Drive, Winter Garden, FL 34787 | 2018-09-10 |
| 1316212517 | Andrew Hunter Petersen | Otolaryngology | 211 W Maple Ave, Fayetteville, WV 25840-1445 | 2012-03-20 |
| 1396883765 | Andrew Petersen | Dentist | 7400 S Power Rd Ste 136, Gilbert, AZ 85297-9284 | 2007-02-01 |
| 1124011572 | Andrew D Petersen | Family Medicine | 524 W 300 N Ste 203, Provo, UT 84601-2669 | 2005-08-31 |
| 1679962138 | Andrew Jameson Petersen | Social Worker | 167 Polk St, Suite 300, Watertown, NY 13601-2770 | 2015-01-21 |
| 1649513078 | Andrew Wei Petersen | Internal Medicine | 375 Dixmyth Ave, Cincinnati, OH 45220-2475 | 2013-04-04 |
| 1689882235 | Andrew Petersen | Technician | 19401 Northline Rd, Southgate, MI 48195-2277 | 2007-05-18 |
| Street Address |
1025 MARSH ST |
| City | MANKATO |
| State | MN |
| Zip Code | 56001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154316206 | James J Milavetz | Internal Medicine | 1025 Marsh St, Mankato, MN 56001-4752 | 2005-09-14 |
| 1811596059 | Kiman Dinh | Pharmacist | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-10-20 |
| 1295349710 | Joseph Flynn | Pharmacist | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-09-02 |
| 1972115962 | Mohamed A Ibrahim | Community Health Worker | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-08-20 |
| 1174147110 | Emily Behrend | Advanced Practice Midwife | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-06-05 |
| 1205455755 | Whitney Farr | Social Worker | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-04-15 |
| 1134765233 | Kay S Williams | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-11-23 |
| 1871138263 | Sydney Mcinnis | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-11-09 |
| 1730739061 | Kelsey Elizabeth Mork | Physician Assistant | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-09-18 |
| 1891345369 | Matthew Joseph Perri | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| 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 |
|---|---|---|---|---|
| 1972743391 | Jacqueline M Samuelson | Physician Assistant | 1961 Premier Dr Ste 330, Mankato, MN 56001-6494 | 2009-02-25 |
| 1609815364 | Leon Hughes | Physician Assistant | 102 S Center St, Mankato, KS 66956-2202 | 2006-06-06 |
| 1871125070 | David Jeremiah Roemhildt | Physician Assistant | 1431 Premier Dr, Mankato, MN 56001-6076 | 2020-02-06 |
| 1780214890 | Sarah Lynnette Martens | Physician Assistant | 1421 Premier Dr, Mankato, MN 56001-6076 | 2020-01-17 |
| 1558907519 | Amber Imani Hogan | Physician Assistant | 1431 Premier Dr, Mankato, MN 56001-6076 | 2019-11-25 |
| 1598314916 | Marissa Ann Spencer | Physician Assistant | 1025 Marsh St, Mankato, MN 56001 | 2019-09-09 |
| 1194373514 | Christina Renee Lindemann | Physician Assistant | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-08-28 |
| 1871145656 | Elizabeth Hovden | Physician Assistant | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-07-12 |
| 1699233965 | Zachary Joel Stevens | Physician Assistant | 1230 E Main St, Mankato, MN 56001-5066 | 2019-03-06 |
| 1134616584 | Shannon Arader | Physician Assistant | 1025 Marsh St, Mankato, MN 56001 | 2018-04-20 |
| Find all providers in MANKATO | ||||
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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.