Active NPI
Kelly Marie Warren, PHARMD
- Pharmacist
- Cloquet, MN
National Provider Identifier
1235504358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 122428
- Practice address
- 1308 Highway 33 S
Cloquet, MN 55720-2653 - Phone
- (218) 878-0676
- NPI assigned
- Dec 1, 2015
- 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 | 18193-40 | WI | |
| Pharmacist | 183500000X | 122428 | MN | Primary |
Addresses
Primary practice location
1308 Highway 33 S
Cloquet, MN 55720-2653
Mailing address
1308 Hwy 33 South
Cloquet, MN 55720
Phone (218) 310-0524
Other practice location 1
1308 Highway 33 S
Cloquet, MN 55720-2653
Phone (218) 878-0676
Other names 1
- Kelly Marie Nelson
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 |
|---|---|---|---|
| 122428 | MN | MD | Pharmacist |
| 18193-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Pharmacy
- Duluth, MN
- NPI 1861407173
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- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653004800000",
"number": "1235504358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1308 HWY 33 SOUTH",
"city": "CLOQUET",
"state": "MN",
"postal_code": "55720",
"telephone_number": "218-310-0524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1308 HIGHWAY 33 S",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557202653",
"telephone_number": "218-878-0676"
}
],
"practiceLocations": [
{
"address_1": "1308 Highway 33 S",
"address_purpose": "LOCATION",
"city": "Cloquet",
"state": "MN",
"postal_code": "557202653",
"country_code": "US",
"telephone_number": "218-878-0676",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WARREN",
"first_name": "KELLY",
"middle_name": "MARIE",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-01",
"last_updated": "2022-05-20",
"certification_date": "2022-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "18193-40",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "122428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "NELSON",
"middle_name": "MARIE",
"credential": "PHARMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cloquet, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.