KELLEY WICHMAN (NPI# 1407390511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407390511 |
Entity Type | Individual |
Full Name | KELLEY WICHMAN |
Credential | CSFA |
Practice Address |
710 Commerce Dr Woodbury MN 55125-4919 |
Practice Telephone | 3202239893 |
Mailing Telephone | 3202239893 |
Enumeration Date | 2016-12-08 |
Last Update Date | 2016-12-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
169459 | MN | Technologists, Technicians & Other Technical Service Providers |
Street Address |
710 COMMERCE DR |
City | WOODBURY |
State | MN |
Zip Code | 55125-4919 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518939099 | Paul M Bruning | Specialist/Technologist | 710 Commerce Dr, Suite 200, Woodbury, MN 55125-4919 | 2006-02-07 |
1912459116 | Erik Collins | Specialist/Technologist | 710 Commerce Dr, Suite 100, Woodbury, MN 55125-4919 | 2016-11-04 |
1659704492 | Matthew Edward Frericks | Specialist/Technologist | 710 Commerce Dr, Woodbury, MN 55125-4919 | 2013-08-15 |
1023170958 | Sarah Fuerst | Counselor | 710 Commerce Dr, Suite 215, Woodbury, MN 55125-4919 | 2006-12-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
Find all providers in zip 55125 |
Taxonomy Code | 246ZC0007X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Specialist/Technologist, Other |
Specialization | Surgical Assistant |
A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training. |
Notes: Source: Association of Surgical Assistants, 2014. [7/1/2014: title modified, definition modified] http://www.surgicalassistant.org/index.php/surgical-assisting Additional Resources: National Surgical Assistant Association, www.nsaa.net. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639710940 | Marissa Malley | Specialist/Technologist, Other | 408 19th St Nw, Rochester, MN 55901-8126 | 2019-10-08 |
1407366537 | Robert Ezike | Specialist/Technologist, Other | 310 98th Ln Nw, Coon Rapids, MN 55433-5613 | 2017-10-03 |
1871739524 | Lori J. Vonbehren | Specialist/Technologist, Other | 9552 Yukon Cir S, Bloomington, MN 55438-1645 | 2008-12-31 |
1487116547 | Augustus Owusu Sarpong | Specialist/Technologist, Other | 1000 W 140th St Unit 201, Burnsville, MN 55337-4833 | 2019-04-05 |
1912420704 | William R Turnquist | Specialist/Technologist, Other | 3580 Arcade St, Vadnais Heights, MN 55127-7135 | 2017-07-24 |
1831628478 | Monica Marie Mckay | Specialist/Technologist, Other | 17 Exchange St W Ste 622, Saint Paul, MN 55102-1225 | 2017-06-07 |
1932635547 | Tina Kretsch | Specialist/Technologist, Other | 17 Exchange St W Ste 622, Saint Paul, MN 55102-1225 | 2017-05-03 |
1922534536 | Cassandra Wittner | Specialist/Technologist, Other | 17 Exchange St W Ste 622, Saint Paul, MN 55102-1225 | 2017-05-03 |
1265779714 | Anna M Bennett | Specialist/Technologist, Other | 14001 Ridgedale Dr, Suite 200, Minnetonka, MN 55305-1753 | 2013-01-03 |
1720367766 | Angela J Brown | Specialist/Technologist, Other | 519 S Galbraith St, Blue Earth, MN 56013-2155 | 2011-08-09 |
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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.