Individual
MARYNNE L KOPISCHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
6545 FRANCE AVE S, STE 210, EDINA, MN 55435-2281
(952) 928-2900
(952) 928-2944
Mailing address
6545 FRANCE AVE S, STE 210, EDINA, MN 55435-2281
(952) 928-2900
(952) 928-2944
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R113270-2
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0410560
MEDICA
MN
01
—
1007082
PREFERREDONE
MN
01
—
151560
UCARE MN
MN
05
—
4305471
—
MT
05
—
43841400
—
WI
05
—
780824100
—
MN
01
—
851169
AMERICA'S PPO
MN
01
—
8T414KO
BLUECROSS BLUE SHIELD MN
MN
01
—
HP33242
HEALTHPARTNERS
MN
Enumeration date
03/16/2006
Last updated
11/17/2011
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