Active NPI
Jessica Koehler
- Pharmacist
- Eagan, MN
National Provider Identifier
1679080592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 123371
- Practice address
- 1500 Central Park Commons Dr
Eagan, MN 55121-8702 - Phone
- (651) 405-3662
- NPI assigned
- Dec 30, 2017
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 123371 | MN | Primary |
Addresses
Primary practice location
1500 Central Park Commons Dr
Eagan, MN 55121-8702
Mailing address
1500 Central Park Commons Dr
Eagan, MN 55121-8702
Phone (651) 405-3662
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123371 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514592000000",
"number": "1679080592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 CENTRAL PARK COMMONS DR",
"city": "EAGAN",
"state": "MN",
"postal_code": "551218702",
"telephone_number": "651-405-3662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 CENTRAL PARK COMMONS DR",
"city": "EAGAN",
"state": "MN",
"postal_code": "551218702",
"telephone_number": "651-405-3662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOEHLER",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-30",
"last_updated": "2017-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "123371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.