ADAM M WENNERSTEN (NPI# 1568619682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568619682 |
| Entity Type | Individual |
| Full Name | ADAM M WENNERSTEN |
| Credential | PA-C |
| Practice Address |
3600 Tower Ave Superior WI 54880 |
| Mailing Address |
3600 Tower Ave Superior WI 54880-5589 |
| Practice Telephone | 7153921955 |
| Mailing Telephone | 7153921955 |
| Mailing Fax Number | 7153921901 |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2018-05-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 11324 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | 2366-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4325 Grand Ave, Duluth, MN 558072730 | 2187221497 |
| Street Address |
3600 TOWER AVE |
| City | SUPERIOR |
| State | WI |
| Zip Code | 54880 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508823782 | Martin Edward Duchscher | Dentist | 3600 Tower Ave, Superior, WI 54880-5337 | 2006-04-29 |
| 1427549674 | Wendy Ann Peterson | Dentist | 3600 Tower Ave, Superior, WI 54880 | 2018-05-23 |
| 1003279332 | Penny Jo Waldum | Registered Nurse | 3600 Tower Ave, Superior, WI 54880-5589 | 2016-04-04 |
| 1245626936 | Hannah Johnston | Registered Nurse | 3600 Tower Ave, Superior, WI 54880-5589 | 2015-04-09 |
| 1891194536 | Cheryl Larsen | Dental Hygienist | 3600 Tower Ave, Superior, WI 54880-5589 | 2014-08-19 |
| 1003164393 | Cathy Marie Baker | Registered Nurse | 3600 Tower Ave, Superior, WI 54880-5337 | 2012-08-17 |
| 1033465687 | Thomas A Linstroth | Dentist | 3600 Tower Ave, Superior, WI 54880-5337 | 2012-08-01 |
| 1629366968 | Aaron Daniel Pust | Social Worker | 3600 Tower Ave, Superior, WI 54880-5589 | 2011-07-20 |
| 1871723593 | Eric D Iwen | Dentist | 3600 Tower Ave, Superior, WI 54880-5589 | 2009-07-15 |
| 1366678773 | Glen E Holt | Obstetrics & Gynecology | 3600 Tower Ave, Superior, WI 54880-5337 | 2009-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427194 | Alana Catherine Sullivan | Speech-Language Pathologist | 25 N 25th Street E, Superior, WI 54880 | 2020-11-05 |
| 1710524970 | Sean Wiberg Peterson | Specialist/Technologist | 1810 Catlin Ave, Room 1246, Superior, WI 54880 | 2019-12-06 |
| 1558858936 | Brent Adam Engstrom | Student in an Organized Health Care Education/Training Program | 1410 Nth 23rd Street, Superior, WI 54880 | 2018-04-20 |
| 1558769125 | David Kroll | Specialist | Balknap & Catlin Aves., Superior, WI 54880 | 2014-12-15 |
| 1154670321 | Superior Treatment Center, Inc | Community/Behavioral Health | 1507 Tower Ave Ste 307, Superior, WI 54880 | 2012-09-04 |
| 1548551658 | Dionne Jeannine Corcoran | Midwife | 916 Hammond Ave Ste 222, Superior, WI 54880 | 2011-04-22 |
| 1821235433 | Lauren Ashley Miller | Speech-Language Pathologist | 35 N. 28th Street, Superior, WI 54880 | 2009-01-20 |
| 1528261989 | Stacy Ann Kennelly | Physical Therapist | 1612 N 37th Street, Superior, WI 54880 | 2007-06-06 |
| 1760564942 | James Henry Dobis | Family Medicine | 3520 Tower Avenue, Twin Ports Va Outpatient Clinic, Superior, WI 54880 | 2006-10-19 |
| 1134214398 | Kevin M Mikel | Dentist | 3312 Tower Avenue, Superior, WI 54880 | 2006-10-04 |
| Find all providers in zip 54880 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023129996 | Blaine S. Jensen | Physician Assistant | 1134 W Hwy 60, Superior, AZ 85273-2647 | 2006-08-31 |
| 1669470845 | James G Potter | Physician Assistant | 3500 Tower Avenue, Superior, WI 54880-5335 | 2005-07-12 |
| 1629401856 | Amy Marie Laflamme | Physician Assistant | 3500 Tower Ave, Superior, WI 54880-5335 | 2013-08-12 |
| 1740539568 | Sarah Elizabeth Johnson | Physician Assistant | 3500 Tower Ave, Essentia Health St. Mary's Hospital-superior, Superior, WI 54880-5335 | 2012-09-07 |
| 1114225174 | Sarah Lynn Karl | Physician Assistant | 3500 Tower Ave, Essentia Health St. Mary's Superior Clinic, Superior, WI 54880-5335 | 2011-03-01 |
| 1245552140 | Matthew Gatlin | Physician Assistant | 525 E 11th St, Superior, NE 68978-1101 | 2010-02-18 |
| 1174690853 | Jay Michael Ferguson | Physician Assistant | 3500 Tower Ave, Superior, WI 54880-5335 | 2006-11-29 |
| 1831290683 | Karyn Thornton | Physician Assistant | 1208 6th Ave, Superior, MT 59872-9618 | 2006-09-26 |
| 1790736981 | Anna Charlotte Greiner | Physician Assistant | 109 N 28th St E, Superior, WI 54880 | 2006-05-13 |
| 1073590626 | Brodstone Memorial Hospital | Physician Assistant | 525 E 11th St, Superior, NE 68978-1101 | 2005-12-26 |
| Find all providers in SUPERIOR | ||||
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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.