MRS. ANDREA JO PITZL


Address: 3208 36th Ave Ne, St Anthony, MN 55418-1713
Phone: 6128055015

MRS. ANDREA JO PITZL (NPI# 1477824472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477824472
Entity Type Individual
Full Name MRS. ANDREA JO PITZL
Other Name ANDREA JO SHAMP
Credential PA-C
Practice Address 3208 36th Ave Ne
St Anthony
MN 55418-1713
Practice Telephone 6128055015
Mailing Telephone 6128055015
Enumeration Date 2012-01-23
Last Update Date 2015-11-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
11081 MN Physician Assistants & Advanced Practice Nursing Providers
N 363AS0400X Physician Assistant
Specialization: Surgical Technologist
1668 MN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN RAILROAD MEDICARE P01138670 01

Office Location

Street Address 3208 36TH AVE NE
City ST ANTHONY
State MN
Zip Code 55418-1713

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NPI Name Taxonomy Address Enumeration
1295347854 Shining Light Skill Building LLC Psychologist 3055 Old Highway 8 Ste 106b, St. Anthony, MN 55418 2020-08-17
1033744008 Star Health Services Clinic/Center 3055 Old High 8, Saint Anthony, MN 55418 2020-03-10
1154974913 Magnolia Home Healthcare LLC Durable Medical Equipment & Medical Supplies 951 Ne Lowry Ave #314, Minneapolis, MN 55418 2019-07-22
1255825345 Senzilla Health Services, LLC Clinic/Center 3035 Old Highway 8, Suite 101f, St. Anthony, MN 55418 2018-06-21
1932642113 Allyson Plumberg Speech-Language Pathologist 2568 Kenzie Terrace, Apt 211, St Anthony, MN 55418 2016-11-21
1053782961 Exel Mobility Inc Non-emergency Medical Transport (VAN) 2302 Central Avenue, Minneapolis, MN 55418 2015-10-19
1447620893 Bille Bus Transportation, Inc Non-emergency Medical Transport (VAN) 2500 Hwy 88, Suite 218, Minneapolis, MN 55418 2015-09-29
1508242108 Caring Companions Home Health Care Home Health 3055 Old High Way 8 Suite 109, St Anthony, MN 55418 2015-08-05
1477934438 Hybrid Behavioral Health Community/Behavioral Health 2221 Polk St Ne, Minneapolis, MN 55418 2015-06-16
1316343551 Hennepin Healthcare Systems, Inc Pharmacy 2714 County Rd 88, Minneapolis, MN 55418 2014-11-17
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1194120204 Nathan C Clapper Physician Assistant 3580 Arcade St Ste 100, Vadnais Heights, MN 55127-7135 2014-10-31
1003180555 Elizabeth K Saterenzoller Physician Assistant 1015 Marsh Street, Mankato, MN 56002-8673 2012-03-01
1447560693 Jeanine Marie Edstrom Physician Assistant 1185 Town Centre Dr Ste 200, Eagan, MN 55123-1343 2010-10-20
1841504792 Michelle R Aumock Physician Assistant 8100 W 78th Street, Ste 230, Edina, MN 55439 2010-08-03
1194042390 Gerald Frederick Anderson Physician Assistant 4060 Haines Rd, #104, Duluth, MN 55811-1746 2010-04-27
1558683904 Oswaldo Serge Physician Assistant 4036 3rd St Nw, Rochester, MN 55901-7564 2010-02-25
1417288945 Amanda Kay Johnson Physician Assistant 201 W Center St Ei-01 Surgical Assistant, Rochester, MN 55902-3003 2010-01-22
1790922755 Jenelle Cecilia Rock Physician Assistant 1950 Northwestern Ave S, Suite 102, Stillwater, MN 55082-7590 2009-01-13
1174775514 Nathan J Nistler Physician Assistant 3580 Arcade Stq, Vadnais Heights, MN 55127-7135 2008-10-16
1811164007 Leah Anne Zupancich Physician Assistant 2545 Chicago Ave. S., Suite 106, Minneapolis, MN 55404 2008-05-15
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Competitor

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City ST ANTHONY
Zip Code 55418

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Dataset Information

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.

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