MEDICARE: DR. ERIKA CHRISTINE JANUSCHKA OD

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
1	152W00000X	Optometrist	2778	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1025066	OTHER	MN	PREFERRED ONE
2	207177	OTHER	MN	EYEMED
3	2201959	OTHER	MN	MEDICA
4	HP37898	OTHER	MN	HEALTHPARTNERS
5	515SZJA	OTHER	MN	BLUE CROSS BLUE SHIELD
6	131052	OTHER	MN	UCARE
7	781105500	OTHER	MN	MN CARE

General Provider Information

NPI Number	:	1487746525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIKA CHRISTINE JANUSCHKA OD

Provider Business Mailing Address
First Line	:	19112 FREEPORT ST NW
Second Line	:
City	:	ELK RIVER
State	:	MN
Zip	:	55330-1266
Country	:	US
Telephone Number	:	763-241-2083
Fax Number	:

Provider Business Practice Location Address
First Line	:	19112 FREEPORT ST NW
Second Line	:
City	:	ELK RIVER
State	:	MN
Zip	:	55330-1266
Country	:	US
Telephone Number	:	763-241-2083
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	07/08/2007

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