Basic Information
Provider Information
NPI: 1790897460
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RESCH
FirstName: KAREN
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2910 CENTRE POINTE DRIVE 35 121A
Address2: CHILDRENS HEALTH CARE
City: ROSEVILLE
State: MN
PostalCode: 55113
CountryCode: US
TelephoneNumber: 6518552109
FaxNumber: 6518552310
Practice Location
Address1: 2525 CHICAGO AVENUE SOUTH
Address2: CHILDRENS HOSPITALS AND CLINICS EMERGENCY PHYSICIANS MP
City: MINNEAPOLIS
State: MN
PostalCode: 55404
CountryCode: US
TelephoneNumber: 6128136843
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 07/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X37163MNN Allopathic & Osteopathic PhysiciansEmergency Medicine 
208000000X37163MNN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0204X37163MNN Allopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
207PP0204X37163MNY Allopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine

ID Information
IDTypeStateIssuerDescription
61551450005MN MEDICAID


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