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NPI Code Detail

MEDICARE: MARYNNE L KOPISCHKE N.P.

MEDICARE: MARYNNE L KOPISCHKE N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerR113270-2MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31007082OTHERMNPREFERREDONE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5851169OTHERMNAMERICA'S PPO
68T414KOOTHERMNBLUECROSS BLUE SHIELD MN
70410560OTHERMNMEDICA
8151560OTHERMNUCARE MN
9HP33242OTHERMNHEALTHPARTNERS

General Provider Information

NPI Number : 1447229026
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYNNE L KOPISCHKE N.P.
Provider Business Mailing Address
First Line : 6545 FRANCE AVE S
Second Line : STE 210
City : EDINA
State : MN
Zip : 55435-2281
Country : US
Telephone Number : 952-928-2900
Fax Number : 952-928-2944
Provider Business Practice Location Address
First Line : 6545 FRANCE AVE S
Second Line : STE 210
City : EDINA
State : MN
Zip : 55435-2281
Country : US
Telephone Number : 952-928-2900
Fax Number : 952-928-2944
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 11/17/2011

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