Individual
MR. JEREMY JOHN BELTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
10307 UNIVERSITY AVE NE, BLAINE, MN 55434-8026
(763) 786-3439
Mailing address
10307 UNIVERSITY AVE NE, BLAINE, MN 55434-8026
(763) 786-3439
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
2475939
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A696845700
—
MN
Enumeration date
05/10/2021
Last updated
05/10/2021
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