Reddy, Jyothsna M
Reddy, Jyothsna M is an individual health care provider with primary practice located at 5502 W Broadway Ave , Crystal MN 55428-3508. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Reddy, Jyothsna M can be contacted via phone (763) 287-6543.Contact Information
Primary practice address
5502 W Broadway Ave
Crystal MN 55428-3508
Phone: (763) 287-6543
Fax: (763) 287-6544
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 34539 | Minnesota |
Profile Details
| NPI number | 1679564132 |
|---|---|
| LBN Legal business name | Reddy, Jyothsna M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 3rd, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679564132 | NPPES |
| Minnesota | MEDICAID | 4640000400 |
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