Active NPI
Jenifer Marie Ekern Watters, RPH
- Pharmacotherapy Pharmacist
- Hastings, MN
National Provider Identifier
1144540188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 114170
- Practice address
- 1175 Nininger Rd
Hastings, MN 55033-1056 - Phone
- (651) 480-4263
- Fax
- (651) 480-4266
- NPI assigned
- Jun 1, 2010
- Last updated
- Jun 1, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 114170 | MN | Primary |
Addresses
Primary practice location
1175 Nininger Rd
Hastings, MN 55033-1056
Mailing address
1175 Nininger Rd
Hastings, MN 55033-1056
Phone (651) 480-4263
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
| License | State | Type | Specialty |
|---|---|---|---|
| 114170 | MN | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275350400000",
"number": "1144540188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1175 NININGER RD",
"city": "HASTINGS",
"state": "MN",
"postal_code": "550331056",
"telephone_number": "651-480-4263",
"fax_number": "651-480-4266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 NININGER RD",
"city": "HASTINGS",
"state": "MN",
"postal_code": "550331056",
"telephone_number": "651-480-4263",
"fax_number": "651-480-4266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTERS",
"first_name": "JENIFER",
"middle_name": "MARIE EKERN",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-01",
"last_updated": "2010-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MN",
"license": "114170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hastings, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.