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NPI Code Detail

MEDICARE: JEANNE MARIE THORESON APRN CNP

MEDICARE: JEANNE MARIE THORESON APRN CNP
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
1363L00000XNurse PractitionerR090654-4MN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2500002597OTHERMNMEDICARE RAILROAD

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 : 1437135654
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNE MARIE THORESON APRN CNP
Provider Business Mailing Address
First Line : 210 9TH ST SE
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-6756
Country : US
Telephone Number : 507-288-3443
Fax Number : 507-529-6622
Provider Business Practice Location Address
First Line : 210 9TH ST SE
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-6756
Country : US
Telephone Number : 507-288-3443
Fax Number : 507-529-6622
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2005
Last Update Date : 03/23/2015

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