Pedersen, Jennifer Elyse

Pedersen, Jennifer Elyse is an individual health care provider with primary practice located at 1131 Jackson Ave , Detroit Lakes MN 56501-3618. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Acupuncturist, Chiropractic Providers / Chiropractor. Chiropractic Providers / Chiropractor is her primary health care specialty. Pedersen, Jennifer Elyse can be contacted via phone (218) 844-5050.

Contact Information

Primary practice address
1131 Jackson Ave Detroit Lakes MN 56501-3618
Phone: (218) 844-5050
Fax: (218) 844-5049
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Acupuncturist 171100000X 575 Minnesota
Chiropractic Providers / Chiropractor 111N00000X 4079 Minnesota

Profile Details

NPI number 1689759383
LBN Legal business name Pedersen, Jennifer Elyse
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2006
Last updated Sep 13th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689759383 NPPES
Minnesota MEDICAID 020960100
Minnesota Other 242T6NO
Minnesota Other 350002650
Minnesota Other 134208196
Minnesota Other 4079
Minnesota Other 0908
Minnesota Other 242T7PE
Minnesota Other 89749
Minnesota Other 647163
Minnesota Other P00229402
Minnesota Other 020960100
Minnesota Other 575

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