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NPI Code Detail

MEDICARE: DR. ANDREA B JOLLEY-PAULET M.D.

MEDICARE: DR. ANDREA B JOLLEY-PAULET M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician46464MN
2207P00000XEmergency Medicine Physician62084WI
3207P00000XEmergency Medicine Physician46464MN
4207Q00000XFamily Medicine Physician35C.001893OH
5207Q00000XFamily Medicine Physician33012SC
6207P00000XEmergency Medicine Physician44971IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154301463
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREA B JOLLEY-PAULET M.D.
Provider Business Mailing Address
First Line : 750 E 34TH ST
Second Line :
City : HIBBING
State : MN
Zip : 55746-2341
Country : US
Telephone Number : 612-770-2607
Fax Number :
Provider Business Practice Location Address
First Line : 750 E 34TH ST
Second Line :
City : HIBBING
State : MN
Zip : 55746-2341
Country : US
Telephone Number : 612-770-2607
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2006
Last Update Date : 11/19/2024

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