MRS. DENISE ROSE GUDVANGEN (NPI# 1508835141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508835141 |
| Entity Type | Individual |
| Full Name | MRS. DENISE ROSE GUDVANGEN |
| Other Name | DENISE JADEKE |
| Credential | LP |
| Practice Address |
603 Bruce St Crookston MN 56716 |
| Mailing Address |
603 Bruce St Po Box 603 Crookston MN 56716-0603 |
| Practice Telephone | 2182813940 |
| Practice Fax Number | 2182816261 |
| Mailing Telephone | 2182813940 |
| Mailing Fax Number | 2182816261 |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3957 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HEALTH PARTNERS | HP28754 | 01 | |
| MN | BCBS OF MN | 41B43JA | 01 |
| MN | UCARE MINNESOTA | 123671 | 01 |
| Street Address |
603 BRUCE ST |
| City | CROOKSTON |
| State | MN |
| Zip Code | 56716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508835133 | Northwestern Mental Health Center | Clinic/Center | 603 Bruce St, Crookston, MN 56716 | 2006-03-16 |
| 1538787841 | Justine Danielle John | Social Worker | 603 Bruce St, Crookston, MN 56716-2914 | 2020-07-13 |
| 1891341319 | Elizabeth Ann Murphy | Nurse Practitioner | 603 Bruce St, Crookston, MN 56716-2914 | 2019-08-12 |
| 1902369275 | Janelle Bernice Artmann | Social Worker | 603 Bruce St, Crookston, MN 56716-2914 | 2019-04-12 |
| 1770047367 | Mandy Leeann Lundby | Social Worker | 603 Bruce St, Crookston, MN 56716-2914 | 2019-01-28 |
| 1184191066 | Valerie Wagner | Counselor | 603 Bruce St, Crookston, MN 56716-2914 | 2018-10-29 |
| 1245711720 | Lindsey Young | Counselor | 603 Bruce St, Crookston, MN 56716-2914 | 2018-08-23 |
| 1912483397 | Amber Dawn Deere | Nurse Practitioner | 603 Bruce St, Crookston, MN 56716-2914 | 2018-07-18 |
| 1336664614 | Matthew Ryan Keller | Social Worker | 603 Bruce St, Crookston, MN 56716-2914 | 2017-08-08 |
| 1265953053 | Martina Mlikota | Counselor | 603 Bruce St, Crookston, MN 56716-2914 | 2017-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942789912 | Savannah Danielle Miller | Pharmacist | 323 S Minnesota Street, Crookston, MN 56716 | 2018-08-10 |
| 1902037377 | David Fernando Frugone Larrea | Internal Medicine | 400 South Minnesota Street, Crookston, MN 56716 | 2009-08-04 |
| 1831327964 | Andres O Makarem | Internal Medicine | 400 S. Minnesota Ave, Crookston, MN 56716 | 2009-06-26 |
| 1255498564 | Ind School District 593 | Local Education Agency (LEA) | 402 Fisher Ave, Crookston, MN 56716 | 2007-01-03 |
| 1821109422 | Marla Rae Love | Dietitian, Registered | 400 S Minnesota Street, Crookston, MN 56716 | 2006-08-31 |
| 1215932728 | Villa St. Vincent | Skilled Nursing Facility | 516 Walsh St, Crookston, MN 56716 | 2005-06-21 |
| 1740769090 | Christine Jane Loff | Physical Therapist | 323 S Minnesota St, Crookston, MN 56716 | 2018-08-08 |
| 1336594449 | Lesmeister Dental LLC | Dentist | 1726 University Ave, Crookston, MN 56716 | 2016-04-26 |
| 1700271012 | Maneesh C. Kanal | Internal Medicine | 323 S Minnesota St, Crookston, MN 56716 | 2015-04-02 |
| 1114270550 | William T Erickson | Dentist | 1726 University Ave, Crookston, MN 56716 | 2012-10-23 |
| Find all providers in zip 56716 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679769236 | Thea L Rothmann | Psychologist | 603 Bruce St, Crookston, MN 56716-2914 | 2007-09-18 |
| 1689635898 | Michal C Jorgens | Psychologist | 603 Bruce St, Crookston, MN 56716-0603 | 2006-03-29 |
| 1700845823 | James Michael Schober | Psychologist | 603 Bruce St, Crookston, MN 56716 | 2006-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899291 | Charlotte Mae Gerth Haanen | Psychologist | 2805 Cliff Rd E, Burnsville, MN 55337-4095 | 2020-10-17 |
| 1386251148 | Andrew Charles Weis | Psychologist | 158 Water St N Ste 1, Northfield, MN 55057-2125 | 2020-09-25 |
| 1861008567 | Natalia V Potapova | Psychologist | 701 Park Ave # S1.110, Minneapolis, MN 55415-1623 | 2020-09-17 |
| 1720691884 | Oluwatosin Alabi | Psychologist | 4124 Quebec Ave N Ste 307, New Hope, MN 55427-1241 | 2020-08-28 |
| 1962014167 | Kate Esterline | Psychologist | 2724 University Ave Se Ste B, Minneapolis, MN 55414-3210 | 2020-08-19 |
| 1013528207 | Stephen Sean Jenkins | Psychologist | 720 Fourth Ave. S., Eastman Hall 305, Saint Cloud, MN 56301 | 2020-08-12 |
| 1699392266 | Jacqueline Suresh Layton | Psychologist | 17324 Glencoe Ave, Lakeville, MN 55044-7429 | 2020-06-30 |
| 1760016109 | Cori Miller | Psychologist | 7300 Metro Blvd Ste 400, Edina, MN 55439-2307 | 2020-02-25 |
| 1831722594 | Collaboration for Psychological Wellness, LLC | Psychologist | 12000 Portland Ave Ste 120, Burnsville, MN 55337-4469 | 2020-02-20 |
| 1780214601 | Jennifer Jacqueline Felinski Kurtz | Psychologist | 16688 Kentucky Ave, Lakeville, MN 55044-4616 | 2020-01-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MRS. DENISE ROSE GUDVANGEN.
| 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.