Individual
PAMELA J IDZIOREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNNP
Contact information
Practice address
4891 MILLER TRUNK HWY, HERMANTOWN, MN 55811-1512
(218) 626-1222
Mailing address
3920 13TH AVE E, SUITE 6, HIBBING, MN 55746-3675
(218) 263-7540
(866) 732-0699
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R077946-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192225400
—
MN
01
—
8G560ID
BCBS
MN
01
—
8G561ID
BCBS
MN
Enumeration date
08/21/2006
Last updated
09/16/2013
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