KATY JEAN SROCK (NPI# 1790138550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790138550 |
Entity Type | Individual |
Full Name | KATY JEAN SROCK |
Credential | CNP |
Practice Address |
520 Nw 5th St Brainerd MN 56401-2902 |
Practice Telephone | 2188293235 |
Mailing Telephone | 2188293235 |
Enumeration Date | 2016-07-18 |
Last Update Date | 2018-11-29 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
R 210000-5 | MN | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
520 NW 5TH ST |
City | BRAINERD |
State | MN |
Zip Code | 56401-2902 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205305406 | Susan Lee Schwankl | Counselor | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2018-11-16 |
1720563919 | William Lee Wilson Jr. | Social Worker | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2018-10-03 |
1962988774 | Rebecca Gonzalez | Nurse Practitioner | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2018-07-15 |
1558717371 | Michelle Kimman | Marriage & Family Therapist | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2016-05-11 |
1689020752 | Megan Kay Mueller | Marriage & Family Therapist | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2016-05-09 |
1881051621 | Miranda Kay Skinner | Counselor | 520 Nw 5th St, Brainerd, MN 56401 | 2016-01-25 |
1639517238 | Jean Kocer | Social Worker | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2013-06-05 |
1649547589 | Mary Darlene Millicent | Counselor | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2011-11-21 |
1154619823 | Tamara Rose Kmecik | Social Worker | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2011-07-15 |
1164725008 | Kimberly Ashley Westaway | Social Worker | 520 Nw 5th St, Brainerd, MN 56401-2902 | 2010-12-15 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396222832 | Nicholas James Manning | Physical Therapist | 7350 Clearwater Rd N, Baxter, MN 56401 | 2018-07-27 |
1952819757 | Hannah Marie Darabi | Physical Therapist | Essentia Health Rehabilitation Services, 2016 South Sixth Street, Brainer, MN 56401 | 2018-01-15 |
1154867406 | Nancy Ann Schauer | Social Worker | 823 Maple Street, Northern Pine Mental Health Center, Brainerd, MN 56401 | 2017-01-10 |
1336530310 | Audrey Jean Twit | Pharmacist | 523 North Third Street, Essentia Health St Joseph's Medical Center, Brainerd, MN 56401 | 2015-02-11 |
1245638584 | The Renneke Chiropractic Clinic | Physical Therapist | 623 Madison St., Brainerd, MN 56401 | 2014-12-19 |
1124420179 | Jenna Niggeler | Acupuncturist | 1001 Kingwood St Ste 119a, Brainerd, MN 56401 | 2014-09-22 |
1073933719 | Nicholas Adam Lesmeister | Orthopaedic Surgery | 2014 South 6th Street, Brainerd, MN 56401 | 2014-04-21 |
1073864666 | Jennifer L. Owens | Marriage & Family Therapist | 4706 Wilderness Ct Ste 101, Brainerd, MN 56401 | 2012-09-24 |
1619297447 | Christine Elaine Smalling | Licensed Practical Nurse | 6317 Estate Circle Drive, Brainerd, MN 56401 | 2010-06-03 |
1528241577 | Dannia Lor Vang | Pharmacist | 2024 South 6th St, Clinic Pharmacy, Brainerd, MN 56401 | 2007-12-13 |
Find all providers in zip 56401 |
Taxonomy Code | 364SP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730542572 | Iris Reproductive Psychiatric Clinic | Clinical Nurse Specialist | 1500 Mcandrews Road W, Ste 227, Burnsville, MN 55337 | 2016-03-30 |
1922159680 | Kristie Lee Sward | Clinical Nurse Specialist | 160 Kellogg Blvd E Ste 8200, Saint Paul, MN 55101-1420 | 2007-01-16 |
1447333513 | Karen Sue Finck | Clinical Nurse Specialist | 615 1st Ave Ne, Suite 310, Minneapolis, MN 55413-2447 | 2006-10-23 |
1548289259 | Judith Hilary Weis | Clinical Nurse Specialist | 27 1st St Sw, Crosby, MN 56441-1417 | 2006-07-19 |
1184170383 | Jessica Michelle Cadriel | Clinical Nurse Specialist | 100 Freeman Dr, Saint Peter, MN 56082-3504 | 2016-08-28 |
1063864395 | Sherryl St.martin | Clinical Nurse Specialist | 3101 Superior Dr Nw, Rochester, MN 55901-1993 | 2016-07-11 |
1386099505 | Luke Schwartz Moretti | Clinical Nurse Specialist | 2450 Riverside Ave, 6a East, Minneapolis, MN 55454-1450 | 2016-04-25 |
1053771428 | Psychnurse P.C. | Clinical Nurse Specialist | 3000 County Road 42 W, Suite 210, Burnsville, MN 55337-4824 | 2016-02-29 |
1396100046 | Jamie Lynn Giles | Clinical Nurse Specialist | 3021 Harbor Ln N, Suite 206, Plymouth, MN 55447-5109 | 2015-12-23 |
1447529854 | Pamela Christian Boldt | Clinical Nurse Specialist | 7580 160th St W, Lakeville, MN 55044-8348 | 2011-12-14 |
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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.