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NPI Code Detail

MEDICARE: JORDAN FIEF VEENENDAAL PA

MEDICARE: JORDAN FIEF VEENENDAAL PA
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
1363A00000XPhysician Assistant15-02325KS

General Provider Information

NPI Number : 1417579988
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN FIEF VEENENDAAL PA
Provider Business Mailing Address
First Line : 830 ELM ST
Second Line :
City : MINNEAPOLIS
State : KS
Zip : 67467-1608
Country : US
Telephone Number : 853-922-1447
Fax Number :
Provider Business Practice Location Address
First Line : 830 ELM ST
Second Line :
City : MINNEAPOLIS
State : KS
Zip : 67467-1608
Country : US
Telephone Number : 853-922-1447
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2020
Last Update Date : 02/04/2025

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Directions to “ JORDAN FIEF VEENENDAAL PA” Practice Location

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