Jayme Nicole Vanrisseghem, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

123290 Issued in MN

Practice address

108 S 6TH St
Brainerd, MN 56401-3575

Phone

(218) 829-0347

NPI assigned

Jan 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jayme Nicole Kinn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1043774250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 311",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564010311",
            "telephone_number": "218-821-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013575",
            "telephone_number": "218-829-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANRISSEGHEM",
        "first_name": "JAYME",
        "middle_name": "NICOLE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "123290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYME",
            "last_name": "KINN",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Valhalla Place Brainerd LLC
• Jon Richard Van Der Hagen, MD
• Alexa Vanalst
• Dannia Lor Vang, PHARMD
• John Vanmoer
• Frank Vasey, MD
• Jennifer Anne-Song Vaughn, M.S.
• David R Vavra, MD
• Tyler John Verworn, M.D.
• Vibe Chiro

• Pharmacist in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.