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NPI Code Detail

MEDICARE: KYLE A CORYELL PHARMD

MEDICARE: KYLE A CORYELL PHARMD
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
11835P2201XAmbulatory Care Pharmacist123779MN

General Provider Information

NPI Number : 1396242764
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE A CORYELL PHARMD
Provider Business Mailing Address
First Line : 4209 WEBBER PKWY
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-1747
Country : US
Telephone Number : 763-581-5750
Fax Number :
Provider Business Practice Location Address
First Line : 4209 WEBBER PKWY
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-1747
Country : US
Telephone Number : 763-581-5750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2018
Last Update Date : 02/13/2025

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Directions to “ KYLE A CORYELL PHARMD” Practice Location

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