DR. JUSTIN ROBERT WIRTH


Address: 4801 Veterans Dr # 111, Saint Cloud, MN 56303-2015
Phone: 3202521670

DR. JUSTIN ROBERT WIRTH (NPI# 1629687124) 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) 1629687124
Entity Type Individual
Full Name DR. JUSTIN ROBERT WIRTH
Other Name DR. JUSTIN ROBERT WIRTH
Credential DNP, APRN, PMHNP-BC
Practice Address 4801 Veterans Dr # 111
Saint Cloud
MN 56303-2015
Mailing Address 15953 47th St Nw
Annandale
MN 55302-3902
Practice Telephone 3202521670
Mailing Telephone 3202903895
Enumeration Date 2020-07-30
Last Update Date 2020-07-30
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
7559 MN Physician Assistants & Advanced Practice Nursing Providers

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Office Location

Street Address 4801 VETERANS DR # 111
City SAINT CLOUD
State MN
Zip Code 56303-2015

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1841800463 Daniel P Lahr Radiologic Technologist St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 2020-08-07
1730798398 County of Stearns Case Management 705 Courthouse Square, St Cloud, MN 56303 2020-07-29
1669007126 Aflah Transportation LLC Non-emergency Medical Transport (VAN) 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 2020-03-05
1609420942 Stephanie Lynne Metzger Nurse Practitioner Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 2019-07-25
1306406947 Willow Tree Acupuncture LLC Acupuncturist 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 2019-06-17
1821553520 Alan Melvin Hoeper Nurse Anesthetist, Certified Registered Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 2019-02-06
1437644465 Brianna Larissa Justin Speech-Language Pathologist St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 2018-06-22
1780186486 Simplicity Health Pa Family Medicine 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 2018-03-08
1639682925 Dereje Beyene Respiratory Therapist, Certified 1406 15th Street North, Saint Cloud, MN 56303 2017-11-09
1740792761 Lisa Ann Horner Nurse Practitioner 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 2017-10-31
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1255976387 Victoria Sybilla Hadley Nurse Practitioner 1900 Centracare Cir, Saint Cloud, MN 56303-5000 2019-11-13
1215579461 Merryssa Lynn Wood Nurse Practitioner 1406 6th Ave N, Saint Cloud, MN 56303-1900 2019-10-09
1790334043 Jeffrey Charles Kessler Nurse Practitioner 4801 Veterans Dr, Saint Cloud, MN 56303 2019-09-10
1508344466 Andrea Margo Petersen Nurse Practitioner 1406 6th Ave N, Saint Cloud, MN 56303-1900 2018-08-02
1114324829 Lucille Lyda Hanson Nurse Practitioner 4801 Veterans Dr, Saint Cloud, MN 56303-2015 2014-11-24
1982007290 Brett Tillman Nurse Practitioner 4801 Veterans Dr, Saint Cloud, MN 56303-2015 2014-09-30
1104905660 Kay Ann Keimig Nurse Practitioner 4801 Veterans Dr, Saint Cloud, MN 56303-2015 2006-11-03

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1285234435 Hawa Warsame Ali Nurse Practitioner 2650 Portland Ave, Minneapolis, MN 55407-1011 2020-10-27
1962009548 Emily Ongaga Nurse Practitioner 43 10 Parkview Circle, Anoka, MN 55303 2020-10-06
1811504038 Rita Jane Giglio Nurse Practitioner 201 Stade Ln, Fairmont, MN 56031-3227 2020-09-30
1568077725 Linda Mongare Nurse Practitioner 3659 Tower Pond Dr, Anoka, MN 55303-8302 2020-09-14
1366056806 Associates In Mental Health and Addiction Services. P.l.l.c Nurse Practitioner 166 W 3rd St Ste 202, Winona, MN 55987-6591 2020-09-02
1891308813 Chelsey Paulson Nurse Practitioner 228 Krays Mill Rd, Cold Spring, MN 56320-4563 2020-08-28
1417560681 Amy Engle Nurse Practitioner 1125 Se 8th Street, Willmar, MN 56201 2020-08-28
1609488964 Heather Mantsch Nurse Practitioner 1900 Silver Lake Rd Nw Ste 100, New Brighton, MN 55112-1786 2020-08-18
1326659210 Monsurat Oluwa-okougbo Nurse Practitioner 1565 11th Ave, Newport, MN 55055-1650 2020-08-13
1336761261 Mission Mental Health LLC Nurse Practitioner 1973 Sloan Pl Ste 50b, Maplewood, MN 55117-2084 2020-05-14
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Competitor

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City SAINT CLOUD
Zip Code 56303

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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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