Susanne Elaine Holmen

Individual provider Active NPI Rehabilitation Practitioner · Park Rapids, MN

NPI 1295887370 · NPPES record last updated May 12, 2010

Key facts

NPI
1295887370
Entity type
Individual (NPI type 1)
Primary specialty
Rehabilitation Practitioner 225400000X
Practice address
515 Bridge St
Park Rapids, MN 56470-1210
Phone
(218) 366-9229
Fax
(218) 237-2520
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Country Associates, Inc. Past
since Mar 15, 2010
Accepting new patients
Peterson Medical Clinics, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Yes

Addresses

Primary practice location

515 Bridge St
Park Rapids, MN 56470-1210

Mailing address

23650 Glory Trail
Park Rapids, MN 56470
Phone (218) 732-3088

Other providers in Park Rapids, MN

All providers in Park Rapids, MN · Rehabilitation Practitioner in Minnesota

Sources for this page

Verify at the official NPI Registry.