MR. THEODORE YNGVE KORSGREN III (NPI# 1497942585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497942585 |
| Entity Type | Individual |
| Full Name | MR. THEODORE YNGVE KORSGREN III |
| Credential | LPN |
| Practice Address |
1717 W. Cowles St. Fairbanks AK 99701-5903 |
| Practice Telephone | 9074516682 |
| Mailing Telephone | 9074516682 |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2012-12-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 5364 | AK | Nursing Service Providers |
| Street Address |
1717 W. COWLES ST. |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-5903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811986037 | Jonathan R. Starr | Internal Medicine | 1717 W. Cowles St., Fairbanks, AK 99701-5926 | 2005-10-20 |
| 1821340142 | Kristen M Sublett | Advanced Practice Midwife | 1717 W. Cowles St., Fairbanks, AK 99701 | 2012-10-10 |
| 1881943447 | Karen Fedelem | Dentist | 1717 W. Cowles St., Fairbanks, AK 99701-5926 | 2012-08-29 |
| 1508972043 | Brian Robb | Physician Assistant | 1717 W. Cowles St., Fairbanks, AK 99701-5903 | 2006-08-21 |
| 1912983800 | William Frank Catelli II | Dentist | 1717 W. Cowles St., Chief Andrew Isaac Health Center Room 2379a, Fairbanks, AK 99701-4899 | 2005-12-21 |
| 1669462206 | Nigel George Wappett | Obstetrics & Gynecology | 1717 W. Cowles St., Fairbanks, AK 99701-5903 | 2005-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659984987 | Resource Center for Parents & Children, Inc. | Social Worker | 726 26th Ave, Suite #2, Fairbanks, AK 99701 | 2020-08-26 |
| 1134738982 | Aaron Paul Sarauer | Behavior Technician | 3121 Lathrop St., Fairbanks, AK 99701 | 2020-07-28 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1902461957 | Jacqueline Marie Rahm | Counselor | Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 | 2019-05-06 |
| 1821588989 | Corrie Wilson | Nurse Practitioner | 1025 Barnette Street, Fairbanks, AK 99701 | 2018-05-15 |
| 1922519305 | Sarishma Sangeeta Lal | Registered Nurse | 815 2nd Ave Ste 122, Fairbanks, AK 99701 | 2017-10-12 |
| 1245690569 | Christine L Simko | Naturopath | 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 | 2016-02-29 |
| 1932581600 | Jennifer Davis | Registered Nurse | 1025 West Barnette St., Fairbanks, AK 99701 | 2015-06-18 |
| 1700272705 | John D. Zipperer Jr Md, LLC | Clinic/Center | 751 Old Richardson Hwy., Fairbanks, AK 99701 | 2015-04-07 |
| 1578957460 | Mara Justine Becker | Physician Assistant | 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 | 2015-03-27 |
| Find all providers in zip 99701 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902247778 | Prentiss Burke | Licensed Practical Nurse | 1223 27th Ave, Fairbanks, ALASKA 99701 | 2013-07-09 |
| 1790020204 | Misty Morna Nickoli | Licensed Practical Nurse | 1717 West Cowels Street, Fairbanks, AK 99701 | 2012-12-10 |
| 1437446549 | Essie Theresa Johnson | Licensed Practical Nurse | 540 4th Ave, 100, Fairbanks, AK 99701-4714 | 2011-07-09 |
| 1073848586 | Elizabeth Marie Doddridge | Licensed Practical Nurse | 1015 Smallwood Trl, Fairbanks, AK 99712-3124 | 2009-10-16 |
| 1093048613 | Eun Jung Moore | Licensed Practical Nurse | 3350 Thomas St, Spc 100, Fairbanks, AK 99709-3828 | 2009-09-14 |
| 1255511895 | Jamie Dewayne Noble | Licensed Practical Nurse | 1717 West Cowles, Fairbanks, AK 99701-5903 | 2007-11-12 |
| 1376172585 | Lucinda Dowdy | Licensed Practical Nurse | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2020-04-08 |
| 1790339695 | Gary Eaker | Licensed Practical Nurse | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2019-07-29 |
| 1134771751 | Sharon Elemento Egana-cabolis | Licensed Practical Nurse | 650 Younker Ct, Fairbanks, AK 99701-7586 | 2019-07-13 |
| 1396397394 | Tamara Lu Thompson | Licensed Practical Nurse | 650 Younker Ct, Fairbanks, AK 99701-7586 | 2019-07-10 |
| Find all providers in FAIRBANKS | ||||
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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.