Individual
JERI LEAH VERGELDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 KEENAN DR, INTERNATIONAL FALLS, MN 56649-2181
(218) 283-9431
(218) 285-6275
Mailing address
2501 KEENAN DR, INTERNATIONAL FALLS, MN 56649-2181
(218) 283-9431
(218) 285-6275
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35532
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32404700
—
WI
05
—
943365100
—
MN
Enumeration date
07/11/2006
Last updated
05/09/2011
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