Basic Information
Provider Information
NPI: 1104081546
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KIRCHER
FirstName: JULIE
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 101 CARING WAY
Address2:  
City: REDWOOD FALLS
State: MN
PostalCode: 562832624
CountryCode: US
TelephoneNumber: 5076372985
FaxNumber: 5076373057
Practice Location
Address1: 101 CARING WAY
Address2:  
City: REDWOOD FALLS
State: MN
PostalCode: 562832624
CountryCode: US
TelephoneNumber: 5076372985
FaxNumber: 5076373057
Other Information
ProviderEnumerationDate: 07/24/2008
LastUpdateDate: 11/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000X  N Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 
363LF0000X407MNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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