Jennifer A Prom in Duluth - Physician Assistant
Jennifer A Prom - NPI 1215948781
Jennifer A Prom is a Physician Assistant in Duluth, Minnesota. Jennifer A Prom practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Jennifer A Prom is 1215948781. The last update date is 2020-12-16.
Jennifer A Prom's current location address is 619 W Central Entrance, Duluth, Minnesota. You can contact this provider via phone number 2182494987 and fax number 2182494989. The mailing address for Jennifer A Prom is 619 W Central Entrance, Duluth, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jennifer A Prom |
|---|---|
| Address | 619 W Central Entrance, Duluth, Minnesota |
| Phone Number | 2182494987 |
| Fax Number | 2182494989 |
| Sole Proprietor | N |
| Credentials | PAC |
NPI Number Detail
| NPI Number | 1215948781 |
|---|---|
| Provider Enumeration Date | 2006-08-10 |
| Last Updated Date | 2020-12-16 |
Provider Mailing Address Detail
| Address | 619 W Central Entrance |
|---|---|
| City | Duluth |
| State | Minnesota (MN) |
| Post Code | 558115448 |
| Phone Number | 2182494987 |
| Fax Number | 2182494989 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 4215 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 157938000 | MN | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Jennifer A Prom by the Centers for Medicare & Medicaid Services?
The Jennifer A Prom has been issued the NPI (National Provider Identifier) 1215948781. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Jennifer A Prom?
The Jennifer A Prom is situated at 619 W Central Entrance, in the city of Duluth, state of MN, with the zip code 558115448.
What is Jennifer A Prom's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jennifer A Prom's specialized field of practice is Physician Assistant, and the corresponding taxonomy code that categorizes this area of specialization is 363A00000X.
When did Jennifer A Prom receive its 1215948781 assignment?
The Jennifer A Prom was assigned its 1215948781 on 2006-08-10, which is the date when this unique identifier was issued to the organization.
As of what date were the details pertaining to Jennifer A Prom last refreshed?
The information related to the Jennifer A Prom, including its address, specialty, and other relevant details, was last updated on 2020-12-16.
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