Wiermaa, Jacquelyn Dawn
Wiermaa, Jacquelyn Dawn is an individual health care provider with primary practice located at 400 E 3Rd St , Duluth MN 55805-1951. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as her primary health care specialty. Wiermaa, Jacquelyn Dawn can be contacted via phone (218) 786-8364.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 45160 | Minnesota |
Profile Details
NPI number | 1366477929 |
---|---|
LBN Legal business name | Wiermaa, Jacquelyn Dawn |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 12th, 2006 |
Last updated | May 9th, 2011 - about 14 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 | 1366477929 | NPPES |
Minnesota | MEDICAID | 087778600 | |
Minnesota | MEDICAID | 34219300 |
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