Individual provider Active NPI

Jeanne Katherine Greisen, RPH

  • Pharmacist
  • Elk River, MN
National Provider Identifier
1043356702
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
118447-5 Issued in MN
Practice address
18185 Zane St NW
Elk River, MN 55330-4505
Phone
(763) 441-5332
Fax
(763) 441-5591
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 118447-5 MN Primary

Addresses

Primary practice location

18185 Zane St NW
Elk River, MN 55330-4505

Mailing address

1392 156TH LN NW
Andover, MN 55304-4562
Phone (763) 434-5570

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
118447-5MNMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043356702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1392 156TH LN NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553044562",
            "telephone_number": "763-434-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18185 ZANE ST NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553304505",
            "telephone_number": "763-441-5332",
            "fax_number": "763-441-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREISEN",
        "first_name": "JEANNE",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "118447-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.