Duane Oliver Koivisto, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

L 63350-3 Issued in MN

Practice address

11400 Julianne Ave N
Stillwater, MN 55082-9436

Phone

(651) 426-3300

Fax

(651) 426-0419

NPI assigned

May 18, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1770876187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2532 1ST AVE S",
            "address_2": "#104",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044368",
            "telephone_number": "612-825-2905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11400 JULIANNE AVE N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550829436",
            "telephone_number": "651-426-3300",
            "fax_number": "651-426-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOIVISTO",
        "first_name": "DUANE",
        "middle_name": "OLIVER",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-18",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "L 63350-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynn Knutson, PA
• Mary Kochendorfer, AUD
• Alisa N Kocian, OTR/L
• Jena Kocur, DPT
• Jenny Kohler
• Donna Marie Koning, M.D.
• John Koska, LADC
• Senja Koski
• Shelby Kotoski
• Susan Kottschade, PSY.D., LP

• Licensed Practical Nurse in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Licensed Practical Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.