ANDREA KETCHAM (NPI# 1821470824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821470824 |
| Entity Type | Individual |
| Full Name | ANDREA KETCHAM |
| Credential | PHARMD |
| Practice Address |
6100 Shingle Creek Pkwy Brooklyn Center MN 55430-2110 |
| Practice Telephone | 7635660143 |
| Mailing Telephone | 7635660143 |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2016-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 122325 | MN | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | 6302 | SD | Pharmacy Service Providers |
| Street Address |
6100 SHINGLE CREEK PKWY |
| City | BROOKLYN CENTER |
| State | MN |
| Zip Code | 55430-2110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013201383 | Luanne Marie Brundage | Pharmacist | 6100 Shingle Creek Pkwy, T-0240, Brooklyn Center, MN 55430-2110 | 2011-06-04 |
| 1376838276 | Robert Francis Stroncek | Pharmacist | 6100 Shingle Creek Pkwy, T-0240, Brooklyn Center, MN 55430-2110 | 2011-06-20 |
| 1922392125 | Randy J Mack | Pharmacist | 6100 Shingle Creek Pkwy, T0240, Brooklyn Center, MN 55430-2110 | 2011-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396362182 | Graceland Homes | Home Health | 6843 Colfax Ave N, Brooklyn Center, MN 55430 | 2020-06-29 |
| 1912549742 | His Services Home Care, LLC | Home Health | 2108 70th Avenue North, Brooklyn Park, MN 55430 | 2019-10-14 |
| 1336612969 | Jeremiah Sk Pojah Sr. | Registered Nurse | 5201 Bryant Avenue North, Suite 108, Minneapolis, MN 55430 | 2019-01-07 |
| 1891219697 | Tamika Yvette Spicer | Home Health Aide | 6640 Humboldt Ave N, 101, Brooklyn Center, MN 55430 | 2017-08-02 |
| 1265973358 | James Contois | Community Based Residential Treatment Facility, Mental Illness | 6120 Earle Brown Drive, Suite 100, Brooklyn Center, MN 55430 | 2017-03-09 |
| 1336693746 | Sara Jean Cooper | Dentist | 1090 Shingle Creek Pkwy, Brooklyn Center, MN 55430 | 2016-08-15 |
| 1750732202 | Miriam Home Health Corporation | Residential Treatment Facility, Physical Disabilities | 7030 Humboldt Avenue North, Brooklyn Center, MN 55430 | 2016-06-27 |
| 1649628561 | Tranquility Health LLC | Community/Behavioral Health | 6040 Earle Brown Dr Ste 250, Brooklyn Center, MN 55430 | 2016-06-01 |
| 1104233790 | Lillie's Helping Hands | In Home Supportive Care | 6407 Camden Ave N, #303, Brooklyn Center, MN 55430 | 2014-07-16 |
| 1063760817 | Wal-mart Stores Inc | Technician/Technologist | 1200 Shingle Creek Crossing, Brooklyn Center, MN 55430 | 2012-08-28 |
| Find all providers in zip 55430 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316332687 | Kirk Johnson | Pharmacist | 6900 Willow Ln, Brooklyn Center, MN 55430-1340 | 2015-04-02 |
| 1013201383 | Luanne Marie Brundage | Pharmacist | 6100 Shingle Creek Pkwy, T-0240, Brooklyn Center, MN 55430-2110 | 2011-06-04 |
| 1558960203 | Peter George Pfeiffer | Pharmacist | 1200 Shingle Creek Xing, Brooklyn Center, MN 55430-2835 | 2020-10-23 |
| 1891393278 | Kelli J Danielson | Pharmacist | 1200 Shingle Creek Xing, Brooklyn Center, MN 55430-2835 | 2020-10-16 |
| 1972114528 | Phillip Joseph Breker | Pharmacist | 6390 Brooklyn Blvd, Brooklyn Center, MN 55429-2600 | 2020-08-16 |
| 1013539543 | Elaine Terry | Pharmacist | 5801 Brooklyn Blvd, Brooklyn Center, MN 55429-2521 | 2020-05-06 |
| 1972902468 | Thong Thao | Pharmacist | 6390 Brooklyn Blvd, Brooklyn Center, MN 55429-2600 | 2014-08-20 |
| 1578849535 | Stacy Louiseb Bates | Pharmacist | 6390 Brooklyn Blvd, Brooklyn Center, MN 55429-2600 | 2011-10-21 |
| 1881970812 | Rachel K Buerman | Pharmacist | 6390 Brooklyn Blvd, Brooklyn Center, MN 55429-2600 | 2011-10-21 |
| 1376838276 | Robert Francis Stroncek | Pharmacist | 6100 Shingle Creek Pkwy, T-0240, Brooklyn Center, MN 55430-2110 | 2011-06-20 |
| Find all providers in BROOKLYN CENTER | ||||
| City | BROOKLYN CENTER |
| Zip Code | 55430 |
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| 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.