JENNIFER LYNN NICKELL (NPI# 1538492103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538492103 |
| Entity Type | Individual |
| Full Name | JENNIFER LYNN NICKELL |
| Other Name | JENNIFER LYNN ARCHER |
| Credential | PHARM D. |
| Practice Address |
3809 42nd Ave S Minneapolis MN 55406-3503 |
| Mailing Address |
13579 Athena Way Rosemount MN 55068-6300 |
| Practice Telephone | 6127287138 |
| Mailing Telephone | 6126440930 |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2019-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
119658 | MN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164832713 | Jennifer Nickell | Dietitian, Registered | 9307 Sw 51st Ave, Portland, OR 97219-5118 | 2014-05-05 |
| 1326645417 | Jennifer Nickell | Registered Nurse | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3079 | 2020-10-02 |
| 1750932661 | Jennifer Nickell | Counselor | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2019-09-23 |
| 1710082433 | Jennifer A Nickell | Obstetrics & Gynecology | 1013 N Main St, Sikeston, MO 63801-5043 | 2006-09-14 |
| Street Address |
3809 42ND AVE S |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55406-3503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972579670 | Angela Dhruvan | Family Medicine | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2006-02-23 |
| 1124438734 | Marissa Drake | Registered Nurse | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2014-05-05 |
| 1689010357 | Jodi Lynn Johnson | Registered Nurse | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2013-05-21 |
| 1780942078 | Deqa Yassin Mohamed | Family Medicine | 3809 42nd Ave S, Minneapolis, MN 55406 | 2012-04-25 |
| 1093005498 | Gennadiy Vasilyevich Shevchenko | Psychiatry & Neurology | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2011-04-19 |
| 1598921108 | Katharine Jones Plosser | Physician Assistant | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2008-08-03 |
| 1922271857 | Sandeep Kalola | Family Medicine | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2008-04-11 |
| 1346432218 | Fairview Clinics | Clinic/Center | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2007-08-15 |
| 1932328226 | Louisa Paul | Family Medicine | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2007-04-24 |
| 1851436539 | Fairview Hiawatha Pharmacy Mtm | Non-Pharmacy Dispensing Site | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2007-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286221 | Hoa Bui | Pharmacist | 4547 Hiawatha, Minneapolis, MN 55406 | 2020-08-17 |
| 1184263253 | Carrie Shannon Nightshade | Acupuncturist | 3706 E 42nd Street, Minneapolis, MN 55406 | 2020-01-06 |
| 1164060059 | Deborah Owen | Acupuncturist | 3706 E 42nd St, Minneapolis, MN 55406 | 2019-12-11 |
| 1194290593 | Noelle Therese Wolf | Counselor | 2637 27th Ave S # 229, Minneapolis, MN 55406 | 2018-10-11 |
| 1255819819 | Ayan Osman Ali | Behavior Technician | 3355 Haiwatha Ave Suite 100, Minneapolis, MN 55406 | 2018-08-04 |
| 1881188597 | Lydia Joy Allison | Massage Therapist | 2933 29th Ave. S., Minneapolis, MN 55406 | 2018-06-15 |
| 1497261770 | Carroll Lee Beaty | Massage Therapist | 2801 42nd Ave. So., Minneapolis, MN 55406 | 2017-12-21 |
| 1578082798 | Capitol Cafe LLC | Home Delivered Meals | 2417 E Franklin Ave, Capitol Cafe, Minneapolis, MN 55406 | 2017-09-19 |
| 1851823942 | Safia Abdulkadir Mohamud | Contractor | 2740 Minnehaha Ave Suit 100, Minneapolis, MN 55406 | 2017-03-29 |
| 1881051944 | Sos Transportation LLC | Non-emergency Medical Transport (VAN) | 3355 Haiwatha Ave Suit 100, Minneapolis, MN 55406 | 2016-01-20 |
| Find all providers in zip 55406 | ||||
| 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 |
|---|---|---|---|---|
| 1174160832 | Susan Jacobson | Pharmacist | One Veterans Drive (119), Minneapolis, MN 55417 | 2019-12-02 |
| 1649594912 | Joel Michael Albers | Pharmacist | West Bank Pharmacy 327 Cedar Ave, Minneapolis, MN 55454 | 2010-03-16 |
| 1366689002 | Saida Mohamed | Pharmacist | 1822 E Lake St, Minneapolis, MN 55407-1879 | 2009-01-16 |
| 1164041851 | Ann Nagle | Pharmacist | 2020 E 28th St, Minneapolis, MN 55407-1394 | 2020-04-13 |
| 1932754421 | Brittney Marie Worth | Pharmacist | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2019-08-02 |
| 1134683675 | Kellianne Tang | Pharmacist | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2019-01-29 |
| 1811478076 | Gina Marie Jennissen | Pharmacist | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2018-08-26 |
| 1396232724 | Rachel Elizabeth Rockwell | Pharmacist | 701 W Broadway Ave, Minneapolis, MN 55411-2611 | 2018-04-20 |
| 1053813170 | Jennifer Ann Zenker | Pharmacist | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2018-03-05 |
| 1396267621 | Lauren Turner Bloch | Pharmacist | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2017-07-07 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55406 |
Please comment or provide details below to improve the information on JENNIFER LYNN NICKELL.
| 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.