Active NPI
Nicole Lay Kruschke, PHARM.D.
- Pharmacist
- Cottage Grove, MN
National Provider Identifier
1144754722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 122156
- Practice address
- 9300 E Point Douglas Rd S
Cottage Grove, MN 55016-4030 - Phone
- (651) 846-2834
- NPI assigned
- Apr 20, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 122156 | MN | Primary |
| Pharmacist | 183500000X | 17149-40 | WI |
Addresses
Primary practice location
9300 E Point Douglas Rd S
Cottage Grove, MN 55016-4030
Mailing address
522 McNamara St
Hastings, MN 55033-3124
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122156 | MN | MD | Pharmacist |
| 17149-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492646400000",
"number": "1144754722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 MCNAMARA ST",
"city": "HASTINGS",
"state": "MN",
"postal_code": "550333124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 E POINT DOUGLAS RD S",
"city": "COTTAGE GROVE",
"state": "MN",
"postal_code": "550164030",
"telephone_number": "651-846-2834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUSCHKE",
"first_name": "NICOLE",
"middle_name": "LAY",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-20",
"last_updated": "2017-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "122156",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "17149-40",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cottage Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.