KELLY ANN HARRIS (NPI# 1326293994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326293994 |
| Entity Type | Individual |
| Full Name | KELLY ANN HARRIS |
| Credential | PHARMD |
| Practice Address |
1406 6th Ave N Pharmacy Saint Cloud MN 56303-1900 |
| Practice Telephone | 3202512700 |
| Practice Fax Number | 3206567048 |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2008-11-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
118150 | MN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477199057 | Kelly M Harris | Counselor | 2531 Briarcliff Rd Ne Ste 203, Atlanta, GA 30329-3017 | 2019-11-19 |
| 1316590755 | Kelly Harris | Dentist | 9110 W Tropicana Ave Unit 393, Las Vegas, NV 89147-8764 | 2019-07-23 |
| 1801331715 | Kelly Harris | Technician, Other | 9266 Louis, Redford, MI 48239-1732 | 2017-01-01 |
| 1669827697 | Kelly Wolenberg Harris | Student in an Organized Health Care Education/Training Program | 3600 Forbes Ave Bldg Suite405, Pittsburgh, PA 15213-3410 | 2016-04-27 |
| 1851753255 | Kelly Rae Harris | Registered Nurse | 16515 S 40th St Ste 135, Phoenix, AZ 85048-0560 | 2016-03-24 |
| 1982904314 | Kelly Harris | Counselor | 631 Arbor Road, Winston-salem, NC 27104 | 2010-11-02 |
| 1184830648 | Kelly Jo Harris | Speech-Language Pathologist | 961 Brunswick Cir, Schaumburg, IL 60193-4250 | 2007-05-14 |
| 1326168956 | Kelly Marie Harris | Speech-Language Pathologist | 404 Sw Talquin Ln, Port Saint Lucie, FL 34986-2062 | 2007-03-29 |
| 1932231032 | Kelly Rae Harris | Counselor | 2510 Chickasaw Blvd., Medical Family Therapy, Ardmore, OK 73401 | 2007-03-12 |
| 1760528491 | Kelly M Harris | Speech-Language Pathologist | 1524 S Big Bend Blvd, Saint Louis, MO 63117-2206 | 2007-01-29 |
| Street Address |
1406 6TH AVE N PHARMACY |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-1900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336149939 | Ralph E Fedor | Radiology | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2005-07-26 |
| 1558962399 | Amanda Lee King | Nurse Practitioner | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-11-06 |
| 1912512302 | Fadumo Hassan | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-09-11 |
| 1083228092 | Kristin Deneille Hazeman | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1901 | 2020-09-07 |
| 1508477845 | Taylor Dean Olson | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-08-11 |
| 1407467749 | Traci Jo Salveson | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-08-11 |
| 1487264164 | Cameron Charles Hendrickson | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-08-06 |
| 1154931475 | Megan Ann Brown | Nurse Practitioner | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-08-01 |
| 1326657255 | Amanda J Dircks | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-07-27 |
| 1003439241 | Mary Elizabeth Amundson | Registered Nurse | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2020-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538699012 | Brett Bowman | Pharmacist | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2017-06-15 |
| 1336588953 | Carrie Ann Engdahl | Pharmacist | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2013-06-17 |
| 1851522981 | Jessica Bruns | Pharmacist | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2009-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417587205 | Pain Partners LLC | Pharmacist | 15225 Wild Wings Court, Minnetonka, MN 55345 | 2020-01-21 |
| 1174160832 | Susan Jacobson | Pharmacist | One Veterans Drive (119), Minneapolis, MN 55417 | 2019-12-02 |
| 1942789912 | Savannah Danielle Miller | Pharmacist | 323 S Minnesota Street, Crookston, MN 56716 | 2018-08-10 |
| 1548751654 | Dustin Adam Kakach | Pharmacist | 600 County Hwy 10, Blaine, MN 55434 | 2018-05-24 |
| 1831642214 | Jennifer Franke | Pharmacist | 24760 Hospital Rd., Red Lake, MN 56671 | 2016-08-02 |
| 1922479062 | Shelby Setniker-eschiti | Pharmacist | 2172 German St, Maplewood, MN 55109-2853 | 2015-10-15 |
| 1336530310 | Audrey Jean Twit | Pharmacist | 523 North Third Street, Essentia Health St Joseph's Medical Center, Brainerd, MN 56401 | 2015-02-11 |
| 1215349584 | Stephen Destefano | Pharmacist | 31419 131st Street, Princeton, MN 55371 | 2014-05-21 |
| 1104259795 | Megan Nimke | Pharmacist | 345 Smith Ave North Pharmacy Department, Children's Hospital & Clinics of Minnesota Pharmacy Dep, St. Paul, MN 55102 | 2013-08-19 |
| 1790033363 | Mary Sauer | Pharmacist | 5615 Xerxes Ave N Ste D, Brooklyn Center, MN 55430-2819 | 2012-08-29 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
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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.