Kendra Lee Gacke, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

125635 Issued in MN

Practice address

320 E Main St
Crosby, MN 56441-1645

Phone

(218) 546-4311

NPI assigned

Aug 19, 2022

Last updated

Aug 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Pharmacy

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1699493197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32852 MARSH PT",
            "city": "AITKIN",
            "state": "MN",
            "postal_code": "564316181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E MAIN ST",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411645",
            "telephone_number": "218-546-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GACKE",
        "first_name": "KENDRA",
        "middle_name": "LEE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "125635",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MN",
            "license": "125635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Paul Fish, D.D.S.
• Matthew Francis Fleming, PA-C
• Kenneth Gerard Fogal, MS VP
• Brittany M Fox, PHARMD, MPH, BCPS
• Kristin Lynn Furan-Kriesel, PSY.D, LP
• Gregory James Gavin, CRNA
• Jennifer A. Giza, PHARMD.
• Melissa M Goble, NP
• Carmon Jocelynn Godfrey, BCBA
• David Daniel Goodwin, MD

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Crosby, MN
• Providers in Crosby, MN by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.