SUSAN LYNN ERTEL (NPI# 1740346436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740346436 |
| Entity Type | Individual |
| Full Name | SUSAN LYNN ERTEL |
| Credential | RPH, CACP |
| Practice Address |
5200 Fairview Blvd Inpatient Pharmacy Wyoming MN 55092-8013 |
| Mailing Address |
6 Sunset Ln North Oaks MN 55127-6454 |
| Practice Telephone | 6519827235 |
| Mailing Telephone | 6514845377 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 113650-4 | MN | Pharmacy Service Providers |
| Street Address |
5200 FAIRVIEW BLVD INPATIENT PHARMACY |
| City | WYOMING |
| State | MN |
| Zip Code | 55092-8013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061371 | Gunnar Jon Erickson | Ophthalmology | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2005-05-24 |
| 1902414378 | Fairview Express Care | General Practice | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2020-07-21 |
| 1023648235 | Cassandra L Etheridge | Physician Assistant | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2020-01-16 |
| 1023652211 | Natasha Lackas | Speech-Language Pathologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-10-31 |
| 1467019414 | Terrence Ellis | Clinical Exercise Physiologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-05-24 |
| 1790341493 | Krystal Kraemer | Dietitian, Registered | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-05-17 |
| 1225509037 | Lauren Downie | Dietitian, Registered | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-12-06 |
| 1861977787 | Magdalen Rene Gadbois | Speech-Language Pathologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-09-26 |
| 1285110338 | Marie Hudalla | Physical Therapist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-07-12 |
| 1023502697 | Molly Levy | Nurse Practitioner | 5200 Fairview Blvd, Wyoming, MN 55092 | 2018-06-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696022 | Wyoming Family Dental | Dentist | 5378 East Viking Blvd., Wyoming, MN 55092 | 2020-10-12 |
| 1851909436 | Matthew Rohlf | Dentist | 5378 E Viking Blvd, Wyoming, MN 55092 | 2020-07-20 |
| 1669013280 | Christina Marie Orde | Technician | 4855 261st Street, Wyoming, MN 55092 | 2019-10-04 |
| 1609425966 | Faith Bouttell | Technician | 25423 Heims Lake Circle, Wyoming, MN 55092 | 2019-09-10 |
| 1275875031 | Fairview Express Care | Clinic/Center | 5130 Fairview Blvd, Suite 101, Wyoming, MN 55092 | 2013-03-20 |
| 1023385242 | St. Croix Orthopaedics, P.a. | Durable Medical Equipment & Medical Supplies | 5200 Fairview Blvd., Wyoming, MN 55092 | 2011-11-17 |
| 1902851876 | Tamara Piroska Petrac-halatsis | Obstetrics & Gynecology | 5200 Fairview Boulevard, Ob/gyn Department, Wyoming, MN 55092 | 2006-05-22 |
| 1376922070 | Carli Lynn Ceder | Physical Therapist | 5130 Fairview Blvd, Wyoming, MN 55092 | 2015-05-27 |
| 1396087433 | Fairview Health Services | Durable Medical Equipment & Medical Supplies | 5130 Fairview Blvd, Suite 104, Wyoming, MN 55092 | 2013-03-26 |
| 1598007726 | Fairview Health Services | Prosthetic/Orthotic Supplier | 5130 Fairview Blvd, Suite 103, Wyoming, MN 55092 | 2013-03-26 |
| Find all providers in zip 55092 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720626526 | Dawn Ngoc Nguyen | Pharmacist | 2926 Florence Dr Sw, Wyoming, MI 49418-9736 | 2019-12-12 |
| 1518494954 | Nhi Uyen Tran | Pharmacist | 3010 Boone Ave Sw, Wyoming, MI 49519-7006 | 2017-05-16 |
| 1407305675 | Timothy Bos | Pharmacist | 2207 Porter St Sw # Condo108, Wyoming, MI 49519-2276 | 2016-09-28 |
| 1518374677 | Todd Anthony Penn | Pharmacist | 4330 Timber Ridge Trl Sw, Apt. 10, Wyoming, MI 49519-6426 | 2014-07-21 |
| 1679850077 | Theodore Wentworth | Pharmacist | 4457 Penny Lane Sw, Wyoming, MI 49418 | 2011-11-14 |
| 1558645127 | Pamela K Mitchell | Pharmacist | 4560 Penny Ln Sw, Wyoming, MI 49418-8324 | 2011-09-30 |
| 1144503723 | Robin A Curtis | Pharmacist | 1550 Gezon Pkwy Sw Ste E-100, Wyoming, MI 49509-9397 | 2011-09-21 |
| 1679854111 | Pam Lowing | Pharmacist | 1550 36th St Sw, Wyoming, MI 49509-3409 | 2011-08-29 |
| 1467627315 | Kassia O'brien | Pharmacist | 21 Kingstown Rd, Wyoming, RI 02898-1101 | 2008-04-22 |
| 1699810648 | Kevin Michael Smith | Pharmacist | 16 Chelsea Farm Dr, Wyoming, RI 02898-1221 | 2007-02-20 |
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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.