Individual provider Active NPI

Agnes Njema Azeh, PHARMD

  • Pharmacotherapy Pharmacist
  • Saint Paul, MN
National Provider Identifier
1760767834
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
119219 Issued in MN
Practice address
99 Maryland Ave W
Saint Paul, MN 55117-4528
Phone
(651) 487-3319
Fax
(651) 487-9794
NPI assigned
Oct 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 119219 MN Primary

Addresses

Primary practice location

99 Maryland Ave W
Saint Paul, MN 55117-4528

Mailing address

99 Maryland Ave W
Saint Paul, MN 55117-4528
Phone (651) 487-3319

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

LicenseStateTypeSpecialty
119219MNMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1760767834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 MARYLAND AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551174528",
            "telephone_number": "651-487-3319",
            "fax_number": "651-487-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 MARYLAND AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551174528",
            "telephone_number": "651-487-3319",
            "fax_number": "651-487-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZEH",
        "first_name": "AGNES",
        "middle_name": "NJEMA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MN",
            "license": "119219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.