VICKI L ROSE (NPI# 1669451589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669451589 |
| Entity Type | Individual |
| Full Name | VICKI L ROSE |
| Credential | PA |
| Practice Address |
1230 E Main St Mankato MN 56002-8674 |
| Mailing Address |
Po Box 8674 1230 E Main St Mankato MN 56002-8674 |
| Practice Telephone | 5076251811 |
| Mailing Telephone | 5076251811 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2020-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
9544 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICA | 0109946 | 01 |
| MN | BCBS | 57B74RO | 01 |
| MN | AMERICAS PPO | 2409706 | 01 |
| MN | PREFERRED ONE | NA2951024933 | 01 |
| MN | UCARE | 140087 | 01 |
| CHAMPUS | 41084933956001C220 | 01 | |
| MN | 741190100 | 05 | |
| MN | HEALTH PARTNERS | HP30956 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366566036 | Vicki J Rose | Counselor | 2323 Windish Dr, Galesburg, IL 61401-9780 | 2007-03-19 |
| 1255317574 | Vicki Chlo Rose | Pediatrics | 1602 Skipwith Rd, Richmond, VA 23229-5205 | 2005-12-19 |
| Street Address |
1230 E MAIN ST |
| City | MANKATO |
| State | MN |
| Zip Code | 56002-8674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154325173 | Kimberly A Aho | Psychiatry & Neurology | 1230 E Main St, Mankato, MN 56001-5066 | 2005-06-08 |
| 1699381418 | Emily Anna Potter | Nurse Practitioner | 1230 E Main St, Mankato, MN 56001-5066 | 2020-09-17 |
| 1699233965 | Zachary Joel Stevens | Physician Assistant | 1230 E Main St, Mankato, MN 56001-5066 | 2019-03-06 |
| 1033674288 | Season Marie Hoffman | Nurse Practitioner | 1230 E Main St, Mankato, MN 56001-8001 | 2019-02-01 |
| 1912471665 | Abby Jo Tibodeau | Dietitian, Registered | 1230 E Main St, Mankato, MN 56001-5066 | 2019-01-16 |
| 1154800886 | Travis Mattson | Physical Therapist | 1230 E Main St, Mankato, MN 56001-8001 | 2018-08-13 |
| 1801383955 | Nathan Evers | Pharmacist | 1230 E Main St, Mankato, MN 56001-5066 | 2018-04-15 |
| 1942704945 | Jennifer Sue Marble | Registered Nurse | 1230 E Main St, Mankato, MN 56001 | 2018-03-23 |
| 1669976742 | Brooke Renee Long | Registered Nurse | 1230 E Main St, Mankato, MN 56001 | 2018-03-22 |
| 1245740463 | Galen Mary Hilgendorf | Physician Assistant | 1230 E Main St, Mankato, MN 56001-5066 | 2017-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518004803 | Karl Philip Roos | Internal Medicine | 1230 East Main Street, Mankato, MN 56002 | 2007-01-30 |
| 1194766055 | Winny W Hung | Emergency Medicine | 1025 Marsh St, Dept. of Emergency Medicine, Mankato, MN 56002 | 2006-06-09 |
| 1316974967 | Dale L Carlson | Optometrist | 220 East Main, Mankato, MN 56002-3387 | 2006-06-27 |
| 1992789986 | Brenda Oian Iv | Marriage & Family Therapist | Blue Earth County Government Center, 410 South 5th Street, Mankato, MN 56002-3526 | 2005-12-02 |
| 1811040769 | County of Blue Earth | Public Health or Welfare | 410 S 5th St, Mankato, MN 56002-3526 | 2007-01-22 |
| 1003180555 | Elizabeth K Saterenzoller | Physician Assistant | 1015 Marsh Street, Mankato, MN 56002-8673 | 2012-03-01 |
| 1962660324 | Hope Rene Bollig | Physician Assistant | 1015 Marsh St, Mankato, MN 56002-8673 | 2008-06-01 |
| 1649324690 | Matthew James Schaefer | Radiology | 1025 Marsh St, Mankato, MN 56002-8673 | 2007-01-23 |
| 1427131895 | Matthew Gerald Pollema | Radiology | 1025 Marsh St, Mankato, MN 56002-8673 | 2006-10-21 |
| 1144217209 | Erin E Bissonnette | Nurse Practitioner | 1230 E. Main Street, Mankato Clinic @ Main Street, Mankato, MN 56002-8674 | 2005-10-04 |
| Find all providers in zip 56002 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053609180 | Victoria Sainsbury Louwagie | Physician Assistant | 1025 Marsh Street, Mankato, MN 56001-4752 | 2011-07-11 |
| 1073808739 | Cheryl Ann Hagen | Physician Assistant | 1230 E Main St, Mankato, MN 56001-5066 | 2011-06-10 |
| 1528399417 | Heidi Ginny Gehrke | Physician Assistant | 1421 Premier Drive, Mankato, MN 56001-5066 | 2010-01-17 |
| 1124358395 | Gabriel Gustav Gehrke | Physician Assistant | 1230 E Main St, Mankato, MN 56001-5066 | 2010-01-11 |
| 1780663781 | Brenda J Kruse | Physician Assistant | 1400 E Madison Ave, Suite 400a, Mankato, MN 56001-5473 | 2006-01-10 |
| 1487633491 | Karie M Soost | Physician Assistant | 1230 E Main St, Mankato Clinic @ Main Street, Mankato, MN 56001-5066 | 2006-01-10 |
| 1134107154 | Jessica M Monsen | Physician Assistant | 1230 E Main St, Mankato Clinic @ Main Street, Mankato, MN 56002-8674 | 2006-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969150 | Isaac Waalen | Physician Assistant | 5420 Circle Down, Minneapolis, MN 55416-1312 | 2020-03-28 |
| 1730643701 | Christina Jones | Physician Assistant | 11850 Blackfoot St Nw Ste 270, Coon Rapids, MN 55433-2593 | 2019-01-24 |
| 1114492964 | Molly Goss | Physician Assistant | 1817 Sunset Dr, Northfield, MN 55057-3246 | 2018-10-09 |
| 1932600160 | Ellen Kathryn Freeman | Physician Assistant | 111 Hundertmark Rd Ste 480, Chaska, MN 55318-1485 | 2018-02-22 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1073051751 | Hannah Elizabeth Rosenthal Danielson | Physician Assistant | 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 | 2017-02-02 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1538545686 | Kathryn Jelle | Physician Assistant | 3931 Louisiana Ave S # 55426, St Louis Park, MN 55426-5000 | 2015-07-30 |
| 1831503267 | Karrah Oliver | Physician Assistant | 205 Roosevelt Ave W, Karlstad, MN 56732-4022 | 2014-06-13 |
| 1477981777 | Melissa Ferraz De Toledo | Physician Assistant | 9145 Springbrook Dr Nw Ste 300, Coon Rapids, MN 55433-5897 | 2013-10-23 |
| Find all providers with the same taxonomy | ||||
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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.