Individual provider Active NPI

Gina Marie Jennissen, PHARM.D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Minneapolis, MN
National Provider Identifier
1811478076
Registry record updated Aug 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
118277 Issued in MN
Practice address
1 Veterans Dr
Minneapolis, MN 55417-2309
Phone
(612) 725-2000
NPI assigned
Aug 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 118277 MN Primary

Addresses

Primary practice location

1 Veterans Dr
Minneapolis, MN 55417-2309

Mailing address

16977 236TH Cir
Hutchinson, MN 55350-5447
Phone (612) 850-2007

Other practice location 1

1095 Highway 15 S
Hutchinson, MN 55350-5000
Phone (320) 234-5000

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
118277MNMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1535241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535241600000",
    "number": "1811478076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16977 236TH CIR",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553505447",
            "telephone_number": "612-850-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-725-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1095 Highway 15 S",
            "address_purpose": "LOCATION",
            "city": "Hutchinson",
            "state": "MN",
            "postal_code": "553505000",
            "country_code": "US",
            "telephone_number": "320-234-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNISSEN",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-26",
        "last_updated": "2018-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MN",
            "license": "118277",
            "primary": true
        }
    ],
    "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 Aug 26, 2018; 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.