Jill Marie Koehler, LDH
Individual provider Active NPI Dental Hygienist · Zimmerman, MN
NPI 1013681279 · NPPES record last updated Aug 2, 2021
Key facts
- NPI
- 1013681279
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- H9107 (MN)
- Practice address
- 14649 246TH Ave NW
Zimmerman, MN 55398-8931 - Phone
- (763) 439-8730
- NPI assigned
- Aug 2, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H9107 | MN | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H9107 | MN | Yes |
Addresses
Primary practice location
14649 246TH Ave NW
Zimmerman, MN 55398-8931
Mailing address
14649 246TH Ave NW
Zimmerman, MN 55398-8931
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jill@mindfulmyomn.com |
Other providers in Zimmerman, MN
- James J King Jr.
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- Amanda Knight
- Knutson Chiropractic PA
- Stacy Ann Knutson
- Life Senior Care Inc.
- Andrew Jon Linn
- Loving Hands Transportation LLC
- Steven R Luginbill
- Leeann Macarthur
All providers in Zimmerman, MN · Dental Hygienist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.