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Contact Information

JOELLEN KOHLMAN PETRICK, MD
712 S CASCADE ST
FERGUS FALLS, MN56537-2913
 Phone: 218-736-8000
 Fax: 218-739-6718
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for JOELLEN KOHLMAN PETRICK · (Female)

NPI Number 1114985454
Status Active
Credentials MD
Entity Individual
Enumeration date 05/03/2006
Last updated 02/17/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 48295
  • ND License # 12070
  • ND Medicaid 16483
Hospital affiliation(s)
  • LAKE REGION HEALTHCARE CORPORATION - (Acute Care)
    712 SOUTH CASCADE
    FERGUS FALLS, MN 56537
  • PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES - (Critical Access)
    1411 STATE HIGHWAY 793
    ELBOW LAKE, MN 56531
  • SANFORD MEDICAL CENTER FARGO - (Acute Care)
    801 BROADWAY NORTH
    FARGO, ND 58122
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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