MARCIA KETTERLING (NPI# 1396895942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396895942 |
Entity Type | Individual |
Full Name | MARCIA KETTERLING |
Credential | FNP C |
Practice Address |
302 N Main St Elgin ND 58533 |
Mailing Address |
300 N 7th St Bismarck ND 58501-4439 |
Practice Telephone | 7015843010 |
Practice Fax Number | 7015843011 |
Mailing Fax Number | 7015843011 |
Enumeration Date | 2007-01-12 |
Last Update Date | 2017-06-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R17917 | ND | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ND | 19632 | 05 | |
ND | BLUE CROSS BLUE SHIELD | 23182 | 01 |
ND | DEA | MK0692524 | 01 |
Street Address |
302 N MAIN ST |
City | ELGIN |
State | ND |
Zip Code | 58533 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821392093 | Home Town Health | Physician Assistant | 302 N Main St, Elgin, ND 58533 | 2011-01-03 |
1083935266 | George S Hsu | Clinic/Center | 302 N Main St, Elgin, ND 58533-7108 | 2010-06-22 |
1255661229 | Hands On Health, Inc. | Occupational Therapist | 302 N Main St, Elgin, ND 58533-7108 | 2010-01-13 |
1558305839 | George S. Hsu | Chiropractor | 302 N Main St, Elgin, ND 58533-7108 | 2006-06-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740820299 | Three In One Physical Therapy, Pllc | Physical Therapist | 207 Main Street North, Elgin, ND 58533 | 2020-01-13 |
1033233150 | Nancy L Mcpherson | Physician Assistant | 603 East St North, Jacobson Memorial Hospital Care Center, Elgin, ND 58533 | 2007-03-16 |
1811036247 | Tyesha Dawn Marie Dent | Physician Assistant | 302 North Main, Elgin, ND 58533 | 2007-02-05 |
1407902919 | Elizabeth Elaine Sundberg | Emergency Medicine | 601 East St. N, Elgin, ND 58533 | 2007-01-26 |
1629165915 | Jacobson Memorial Hospital Care Center | Skilled Nursing Facility | 601 E Street N, Elgin, ND 58533 | 2006-10-06 |
1013012327 | Family Vision Clinic LLP | Optometrist | 110 Main St N, Elgin, ND 58533 | 2006-09-13 |
1508161811 | Deepak Manmohan Goyal | Internal Medicine | 603 East St N, Elgin, ND 58533 | 2011-01-18 |
1023036050 | Economy Drug Inc | Pharmacy | 201 N Main St, Elgin, ND 58533 | 2006-07-17 |
1871691519 | Jacobson Memorial Hospital Care Center | Clinic/Center | 603 East St N, Elgin, ND 58533-7105 | 2006-09-20 |
1336196039 | Jacobson Memorial Hospital Care Center | General Acute Care Hospital | 601 East St N, Elgin, ND 58533-7105 | 2006-05-28 |
Find all providers in zip 58533 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801496328 | Kellie Soria | Nurse Practitioner | 8600 Showers Dr, Elgin, TX 78621-5278 | 2020-10-26 |
1669079901 | Kelley Brown Davis | Nurse Practitioner | 2689 Us-1, Elgin, SC 29045 | 2020-10-08 |
1083266878 | Jean K Kombwa | Nurse Practitioner | 66 Grove Ct, Elgin, IL 60120-5588 | 2019-07-11 |
1407416324 | Gloria Benoit Williams | Nurse Practitioner | 889 Royal Oak Way, Elgin, SC 29045-8012 | 2019-06-13 |
1538681671 | Josephina Pilolli | Nurse Practitioner | 2490 Bushwood Dr, Unit F, Elgin, IL 60124 | 2017-07-11 |
1598204638 | Kimberly Horton | Nurse Practitioner | 153 Dawson Dr, Elgin, IL 60120-6409 | 2017-02-22 |
1073961314 | Annie Kluch | Nurse Practitioner | 801 Villa St, Elgin, IL 60120-8001 | 2016-05-26 |
1639543937 | Grace Marie Roxas | Nurse Practitioner | 2025 Salem Road, Elgin, IL 60123-9006 | 2015-11-24 |
1942674585 | Monica Rose Herdrich | Nurse Practitioner | 1665 Larkin Ave, Elgin, IL 60123-5977 | 2015-11-19 |
1073995916 | Betty Lois Pratt | Nurse Practitioner | 373 Summit St Ste 102, Elgin, IL 60120-3748 | 2015-06-28 |
Find all providers in ELGIN |
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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.