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General NPI Number Information
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NPI Number | 1255034146
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Entity Type | Individual
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Provider Name | JESSICA LEIGH STARFIELD KORAN APRN, CNP
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Gender | Female
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Dates
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Enumeration Date | 03/22/2023
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 7400 33RD ST N STE 100
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City | OAKDALE
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State | MN
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Zip | 55128-3630
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Country | US
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Telephone | 651-241-9240
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Fax | 651-241-9241
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Provider Business Mailing Address
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Address Line | 2925 CHICAGO AVENUE
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-1321
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Country | US
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Telephone | 612-262-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 10034
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 10034
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License Number State | MN
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