MRS. JESSICA MARY WAKS (NPI# 1427289222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427289222 |
| Entity Type | Individual |
| Full Name | MRS. JESSICA MARY WAKS |
| Other Name | MS. JESSICA MARY FULTON |
| Credential | C.N.P. |
| Practice Address |
270 Main St N Ste 300 Stillwater MN 55082 |
| Mailing Address |
270 Main St N Ste 300 Stillwater MN 55082-6788 |
| Practice Telephone | 6513421039 |
| Mailing Telephone | 6513421039 |
| Mailing Fax Number | 6513421428 |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2020-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | R-164801-8 | MN | Nursing Service Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
1296 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 421 Main St S, Stillwater, MN 550825172 | 6513421039 | 6513421428 |
| Street Address |
270 MAIN ST N STE 300 |
| City | STILLWATER |
| State | MN |
| Zip Code | 55082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235115791 | John Thomas Murphy | Family Medicine | 270 Main St N Ste 300, Stillwater, MN 55082-6788 | 2005-12-16 |
| 1194336412 | Anna Kaci Renner | Physician Assistant | 270 Main St N Ste 300, Stillwater, MN 55082-6788 | 2020-08-11 |
| 1851915086 | Jennifer Evelyn Paine | Nurse Practitioner | 270 Main St N Ste 300, Stillwater, MN 55082-6788 | 2020-06-03 |
| 1770105033 | Shannon Lynn Mcalpine | Nurse Practitioner | 270 Main St N Ste 300, Stillwater, MN 55082-6788 | 2020-05-09 |
| 1750917985 | Marisa L Felker | Family Medicine | 270 Main St N Ste 300, Stillwater, MN 55082-6788 | 2020-03-19 |
| 1407481591 | Marsha M Nelson | Psychiatry & Neurology | 270 Main St N Ste 300, Stillwater, MN 55082-6788 | 2020-03-09 |
| 1093361875 | Manisha Dharmesh Shah | Nurse Practitioner | 270 Main St N Ste 300, Stillwater, MN 55082-6788 | 2019-08-16 |
| 1184182420 | Allison Fiedler | Nurse Practitioner | 270 Main St N Ste 300, Stillwater, MN 55082-6788 | 2019-03-06 |
| 1952865875 | Brian Traeger | Physician Assistant | 270 Main St N Ste 300, Stillwater, MN 55082-6788 | 2019-01-24 |
| 1598251308 | Heather Horgen | Physician Assistant | 270 Main St N Ste 300, Stillwater, MN 55082-6788 | 2018-07-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
| 1982238085 | Jerald Haley | Technician | 924 6th Ave. S., Stillwater, MN 55082 | 2020-02-27 |
| 1801457387 | Sun Trad Chin Acu Mn LLC | Acupuncturist | Compass Center for Healing, 116 Chestnut St. E., Stillwater, MN 55082 | 2019-06-25 |
| 1598243990 | Carlson Distinctive Dentistry, Pllc | Dentist | 1701 Curve Crest Blvd W Ste 100, Stillwater, MN 55082 | 2018-07-30 |
| 1073001624 | Lindsay Beth Briggs | Chiropractor | 200 Chestnut St E, Ste 202, Stillwater, MN 55082 | 2018-04-30 |
| 1578932943 | Group Health Plan, Inc | Family Medicine | 921 Greeley Street, Stillwater, MN 55082 | 2015-09-16 |
| 1184001919 | Grant Rohrig | Specialist/Technologist | 8727 Jeffrey Ave North, Stillwater, MN 55082 | 2015-04-30 |
| 1346688991 | Kellie Ann Seth | Chiropractor | 200 Chestnut St E Ste 202, Stillwater, MN 55082 | 2013-06-05 |
| 1770928426 | Rivertown Animal Hospital | Veterinarian | 135 New England Place, Stillwater, MN 55082 | 2013-05-08 |
| 1285929265 | Healtheast Medical Research Institute | Dietitian, Registered | 2900 Curve Crest Blvd, Stillwater, MN 55082 | 2011-06-17 |
| Find all providers in zip 55082 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619587193 | Sadiya Abdirahman Esse | Nurse Practitioner | 1690 Silver Lake Rd Nw, New Brighton, MN 55112-1788 | 2020-08-09 |
| 1881226512 | Abby Marie Zenner | Nurse Practitioner | 1771 Countryside Dr, Shakopee, MN 55379-4451 | 2020-02-11 |
| 1174019038 | Adedayo Temitope Dosumu | Nurse Practitioner | 816 50th Ave Nw, Rochester, MN 55901-6554 | 2018-07-03 |
| 1407223159 | Carla Sue Christenson | Nurse Practitioner | 3400 W. 66th St, Edina, MN 55435 | 2015-08-28 |
| 1538573449 | Rebecca Anne Lenz | Nurse Practitioner | 1172 Randolph Ave Apt 8, Saint Paul, MN 55105-2987 | 2014-06-18 |
| 1083027536 | Mueni C Mualuko | Nurse Practitioner | 2220 Riverside Ave # Ms 26602g, Geriatrics Department Ms 26602g/ 2220 Riverside Ave, Minneapolis, MN 55454-1321 | 2014-06-03 |
| 1659623999 | Joy Laansma | Nurse Practitioner | 3366 Oakdale Avenue North, Suite 551, Robbinsdale, MN 55422-2948 | 2012-10-10 |
| 1720337694 | Zhonghua Xie | Nurse Practitioner | 1202 5th Grant Blvd W, Wabasha, MN 55981-1115 | 2012-09-06 |
| 1487937892 | Jonathan Deforest Olson | Nurse Practitioner | 30 W 22nd St, #204, Minneapolis, MN 55404-2428 | 2011-09-21 |
| 1548577224 | Lorene Ann Gray | Nurse Practitioner | 6465 W Shadow Lake Dr, Lino Lakes, MN 55014-1982 | 2010-09-02 |
| Find all providers with the same taxonomy | ||||
| City | STILLWATER |
| Zip Code | 55082 |
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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.