Basic Information
Provider Information | |||||||||
NPI: | 1174805618 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ASKEA | ||||||||
FirstName: | REBECCA | ||||||||
MiddleName: | K | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | GROTEWIEL-TROTTER | ||||||||
OtherFirstName: | REBECCA | ||||||||
OtherMiddleName: | K | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | MD | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 11995 SINGLETREE LN STE 500 | ||||||||
Address2: |   | ||||||||
City: | EDEN PRAIRIE | ||||||||
State: | MN | ||||||||
PostalCode: | 553445349 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9525951301 | ||||||||
FaxNumber: | 6122944903 | ||||||||
Practice Location | |||||||||
Address1: | 11995 SINGLETREE LN STE 500 | ||||||||
Address2: |   | ||||||||
City: | EDEN PRAIRIE | ||||||||
State: | MN | ||||||||
PostalCode: | 553445349 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9525951301 | ||||||||
FaxNumber: | 6122944903 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/11/2011 | ||||||||
LastUpdateDate: | 06/25/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 06/25/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 0101261775 | VA | Y |   | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 208D00000X | 0101261775 | VA | N |   | Allopathic & Osteopathic Physicians | General Practice |   |
No ID Information.