Healthcare Provider Details

I. General information

NPI: 1790579878
Provider Name (Legal Business Name): JENNIFER MARIE ACHMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 2ND ST SW
WILLMAR MN
56201-3337
US

IV. Provider business mailing address

502 2ND ST SW
WILLMAR MN
56201-3337
US

V. Phone/Fax

Practice location:
  • Phone: 320-235-7232
  • Fax: 320-231-8051
Mailing address:
  • Phone: 320-235-7232
  • Fax: 320-231-8051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2081946-2626417
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12895
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: