Provider Demographics
NPI:1255034146
Name:KORAN, JESSICA LEIGH STARFIELD (APRN, CNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEIGH STARFIELD
Last Name:KORAN
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LEIGH
Other - Last Name:STARFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2925 CHICAGO AVENUE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-5000
Mailing Address - Fax:
Practice Address - Street 1:7400 33RD ST N
Practice Address - Street 2:STE 100
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-3630
Practice Address - Country:US
Practice Address - Phone:651-241-9240
Practice Address - Fax:651-241-9241
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10034363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology