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General NPI Number Information
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NPI Number | 1710275128
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Entity Type | Individual
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Provider Name | MEGAN JENNIE BAERTSCH NP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 1420 LONDON RD STE 100
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City | DULUTH
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State | MN
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Zip | 55805-2437
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Country | US
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Telephone | 218-728-8548
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Fax | 763-450-3986
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Provider Business Mailing Address
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Address Line | 2824 JEAN DULUTH RD
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City | DULUTH
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State | MN
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Zip | 55804-2660
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Country | US
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Telephone | 218-780-7773
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R 179432-8
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License Number State | MN
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