# JAN K. SIEBERSMA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1952303216
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 8076A | WY | Yes |
| 207VG0400X | Gynecology Physician | 92-345 | NM | — |

## Other

- **Enumeration date:** 06/01/2005
- **Last updated:** 06/15/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 25802 | PRES | NM |
| 01 | — | 5275478 | LOVELACE | NM |
| 05 | — | F6662 | — | NM |
| 01 | — | NM009818 | BCBS | NM |