Active NPI
Kylee Funk, PHARMD
- Pharmacist
- Minneapolis, MN
National Provider Identifier
1760873269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 122050
- Practice address
- 308 Harvard St SE
Minneapolis, MN 55455-0353 - Phone
- (612) 301-8316
- NPI assigned
- Feb 5, 2015
- Last updated
- Feb 5, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 122050 | MN | Primary |
| Pharmacist | 183500000X | 5302038942 | MI |
Addresses
Primary practice location
308 Harvard St SE
Minneapolis, MN 55455-0353
Mailing address
4249 Stinson Blvd
Columbia Heights, MN 55421-3357
Phone (815) 919-3603
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 |
|---|---|---|---|
| 5302038942 | MI | MD | Pharmacist |
| 122050 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423094400000",
"number": "1760873269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4249 STINSON BLVD",
"city": "COLUMBIA HEIGHTS",
"state": "MN",
"postal_code": "554213357",
"telephone_number": "815-919-3603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 HARVARD ST SE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550353",
"telephone_number": "612-301-8316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNK",
"first_name": "KYLEE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-05",
"last_updated": "2015-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "122050",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302038942",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.