Elizabeth A Detlie (NPI# 1114933744, PAC ID# 7719993575) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1114933744 |
| PAC ID by PECOS | 7719993575 |
| Professional Enrollment ID | I20060302000556 |
| Full Name | Elizabeth A Detlie |
| Organization Legal Name | FAMILY HEALTHSERVICES MINNESOTA, P.A. |
| Address |
404 Hwy 96 W Shoreview MN 55126-1901 |
| Phone Number | 6514838283 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF SOUTH DAKOTA SCHOOL OF MEDICINE |
| Graduation Year | 1982 |
| Primary Specialty | FAMILY PRACTICE |
| Group Practice PAC ID | 1355369018 |
| Number of Group Practice Members | 70 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 240063 | ST JOSEPH'S HOSPITAL |
| 240210 | HEALTHEAST ST JOHN'S HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 404 Hwy 96 W, Shoreview, MN 55126-1901 | 6514838283 | FAMILY HEALTHSERVICES MINNESOTA, P.A. |
| Organization Legal Name | FAMILY HEALTHSERVICES MINNESOTA, P.A. |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carol K Stark | Family Practice | Family Healthservices Minnesota, P.a. | 2716 E Upper Afton Rd, Maplewood, MN 55119-4780 |
| Mark A Steinhauser | Family Practice | Family Healthservices Minnesota, P.a. | 2716 E Upper Afton Rd, Maplewood, MN 55119-4780 |
| Christian P Anderson | Family Practice | Family Healthservices Minnesota, P.a. | 404 Hwy 96 W, Shoreview, MN 55126-1901 |
| Johanna Toninato | Family Practice | Family Healthservices Minnesota, P.a. | 234 E Wentworth Ave, West St Paul, MN 55118-3525 |
| Trisha K Burt | Physician Assistant | Family Healthservices Minnesota, P.a. | 2716 E Upper Afton Rd, Maplewood, MN 55119-4780 |
| Robert R Weber | Family Practice | Family Healthservices Minnesota, P.a. | 404 Hwy 96 W, Shoreview, MN 55126-1901 |
| Natalie L Carstenbrock | Nurse Practitioner | Family Healthservices Minnesota, P.a. | 7180 10th St N, Oakdale, MN 55128-1122 |
| John J Vukelich | Family Practice | Family Healthservices Minnesota, P.a. | 2980 Buckley Way, Inver Grove Heights, MN 55076-2017 |
| Stephanie L Hemmer | Family Practice | Family Healthservices Minnesota, P.a. | 8325 City Centre Dr, Woodbury, MN 55125-3323 |
| John O Punderson | Family Practice | Family Healthservices Minnesota, P.a. | 234 E Wentworth Ave, West St Paul, MN 55118-3525 |
| Street Address |
404 HWY 96 W |
| City | SHOREVIEW |
| State | MN |
| Zip | 55126-1901 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Garrett R Trobec | Family Medicine | Family Healthservices Minnesota, P.a. Dba Entira Family Clinics | 404 Hwy 96 W, Shoreview, MN 55126-1901 |
| Bryan Alm | Physical Therapy | Therapy Partners Inc | 404 Hwy 96 W, Suite E, Shoreview, MN 55126-1900 |
| Lynn C Sedlack | Nurse Practitioner | Family Healthservices Minnesota, P.a. Dba Entira Family Clinics | 404 Hwy 96 W, Shoreview, MN 55126-1901 |
| Christian P Anderson | Family Practice | Family Healthservices Minnesota, P.a. | 404 Hwy 96 W, Shoreview, MN 55126-1901 |
| Robert R Weber | Family Practice | Family Healthservices Minnesota, P.a. | 404 Hwy 96 W, Shoreview, MN 55126-1901 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lori D Lukovsky | Chiropractic | 3550 Lexington N Ave, Suite 210, Shoreview, MN 55126 | |
| Lowell P Magelssen | Chiropractic | 1042 Hwy 96 W, Shoreview, MN 55126-1913 | |
| Jane M Bye | Chiropractic | 500 W Hwy 96 150, Shoreview, MN 55126-1945 | |
| Duane R John | Chiropractic | 4535 Hodgson Rd, Shoreview, MN 55126-1949 | |
| Gerald T Lalla | Chiropractic | 520 Hwy 96 W 200, Shoreview, MN 55126-1963 | |
| John A Stoltzfus | Psychologist, Clinical | 521 Tanglewood Dr, Shoreview, MN 55126-2016 | |
| Penny S Giesbrecht | Psychologist, Clinical | 521 Tanglewood Dr, Shoreview, MN 55126-2016 | |
| Dale E Grossman | Psychologist, Clinical | 521 Tanglewood Dr, Shoreview, MN 55126-2016 | |
| Maryanne A Lassegard | Psychologist, Clinical | 521 Tanglewood Dr, Shoreview, MN 55126-2016 | |
| Roger L Burtraw | Physical Therapy | Infinite Health Collaborative Pa | 4570 Churchill St, Suite 300, Shoreview, MN 55126-2274 |
| Find all physicians in zip 55126 | |||
| City | SHOREVIEW |
| Zip Code | 55126 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | SHOREVIEW + FAMILY PRACTICE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.