JEREMY LEE COUDRON (NPI# 1215547757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215547757 |
| Entity Type | Individual |
| Full Name | JEREMY LEE COUDRON |
| Credential | NP |
| Practice Address |
4050 Coon Rapids Blvd Nw Coon Rapids MN 55433-2522 |
| Practice Telephone | 6517477676 |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2020-08-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 7594 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4050 COON RAPIDS BLVD NW |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134126238 | Adam Lee Gunder | Internal Medicine | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2005-07-05 |
| 1851915177 | Naomi Benjamin | Clinical Nurse Specialist | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2020-06-02 |
| 1912527920 | Dawn Hadley | Physical Therapy Assistant | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2020-04-20 |
| 1275153348 | Tyler Daniel Mathiason | Physical Therapist | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2020-04-20 |
| 1003436346 | Jennifer Gordon Hakes | Physical Therapist | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2020-04-16 |
| 1821617739 | Krista Michelle Holter | Speech-Language Pathologist | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2020-04-10 |
| 1508485459 | Kristin Dianne Forsythe | Physical Therapist | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2020-04-10 |
| 1134748338 | Denise Kay Kaehler | Physical Therapy Assistant | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2020-04-09 |
| 1942829148 | Kelsey Steinbrecher | Occupational Therapist | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2020-04-09 |
| 1063031078 | Valerie Marquardt | Speech-Language Pathologist | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2020-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265831317 | Jacy Stone | Nurse Practitioner | 3332 132nd Cir Nw, Coon Rapids, MN 55448-1075 | 2014-08-14 |
| 1295771996 | Cynthia Laramy Ahler | Nurse Practitioner | 9574 Foley Boulevard Nw, Head Start Building, Coon Rapids, MN 55433 | 2006-06-21 |
| 1255392353 | Robin R Uithoven | Nurse Practitioner | 11850 Blackfoot St Nw, Suite 100, Coon Rapids, MN 55433-2578 | 2006-03-29 |
| 1659346989 | Barbara A Hoglund | Nurse Practitioner | 10081 Dogwood St Nw Ste 100, Coon Rapids, MN 55448-5282 | 2006-02-21 |
| 1235745126 | Allison Usset Gilles | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2020-09-16 |
| 1942776885 | Nicole Terese Radke | Nurse Practitioner | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | 2018-10-18 |
| 1083191316 | Rachel Margaret Bethke | Nurse Practitioner | 4040 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-4567 | 2018-07-19 |
| 1407391279 | Catherine Breiwick | Nurse Practitioner | 2104 Northdale Blvd Nw Ste 220, Coon Rapids, MN 55433-3046 | 2017-01-03 |
| 1689074155 | Stephanie Rae Walvatne | Nurse Practitioner | 3887 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2518 | 2014-09-02 |
| 1871903807 | Cheryl Jarvis | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2014-04-29 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.