Individual
CHAD ROGER FEDJE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
11911 210TH ST, BARRETT, MN 56311-1113
(830) 279-4058
Mailing address
11911 210TH ST, BARRETT, MN 56311-1113
(830) 279-4058
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R-213631-2
MN
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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