DR. KATI JO KAUSHAL (NPI# 1619452455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619452455 |
| Entity Type | Individual |
| Full Name | DR. KATI JO KAUSHAL |
| Credential | DNP |
| Practice Address |
11850 Blackfoot St Nw Ste 300 Coon Rapids MN 55433-2772 |
| Mailing Address |
2925 Chicago Ave Minneapolis MN 55407-1321 |
| Practice Telephone | 7632369000 |
| Mailing Telephone | 6122625000 |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2019-03-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
2015174 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
6215 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12350 Lever St Ne, Blaine, MN 554496642 | 6515290272 |
| Street Address |
11850 BLACKFOOT ST NW STE 300 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811961675 | David D Brusven | Surgery | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2006-02-16 |
| 1023524204 | Chelsie Nicole Horner | Physician Assistant | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2017-12-24 |
| 1770932626 | Anna M Drewry | Obstetrics & Gynecology | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2016-06-10 |
| 1699120972 | Kathleen Ireland | Obstetrics & Gynecology | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2016-04-25 |
| 1831519636 | Derek Goerke | Surgery | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2014-04-18 |
| 1427489772 | Kaley Ingenito | Physician Assistant | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2013-12-11 |
| 1548580442 | Rachelle N. Damle | Surgery | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2010-06-03 |
| 1710140389 | Samy Mokhtar Maklad | Surgery | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2008-07-03 |
| 1548479124 | Nancy Weaver Webster | Obstetrics & Gynecology | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2007-05-21 |
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659763928 | Teresa Cyrus | Nurse Practitioner | 354 123rd Cir Nw, Coon Rapids, MN 55448-2677 | 2015-02-24 |
| 1891029872 | Paul T. Linson | Nurse Practitioner | 9055 Springbrook Dr Nw # Mw, Coon Rapids, MN 55433-5841 | 2009-09-24 |
| 1841285848 | Laurie Marha King | Nurse Practitioner | 12900 Riverdale Dr Nw, Coon Rapids, MN 55448-1063 | 2005-09-15 |
| 1346887585 | Andria Sammon | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2019-12-06 |
| 1588146732 | Erika Janet Hachey | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2018-09-04 |
| 1992220594 | Laila Summer Akhter | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2017-08-04 |
| 1568856599 | David Thomson | Nurse Practitioner | 4040 Coon Rapids Blvd Nw, 120, Coon Rapids, MN 55433-4567 | 2015-03-27 |
| 1356739940 | Julia Kathryn Botzet | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2015-01-05 |
| 1366849788 | Stephanie Hecklin | Nurse Practitioner | 4040 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-4568 | 2014-12-01 |
| 1891114922 | Kelli Sue Lakeman | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2014-04-16 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on DR. KATI JO KAUSHAL.
| 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.