Individual
JEREMY LEE COUDRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4050 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2522
(651) 747-7676
Mailing address
4050 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2522
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7594
MN
Other
Enumeration date
08/07/2020
Last updated
04/25/2023
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