Individual
JORI L EIDEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
132 17TH AVE NW, ROCHESTER, MN 55901-0321
(507) 292-7411
Mailing address
132 17TH AVE NW, ROCHESTER, MN 55901-0321
(507) 292-7411
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1967-023
WI
363A00000X
Physician Assistant
Primary
9884
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
824682300
—
MN
05
—
ENROLLED
—
MN
01
—
P00996318
RAILROAD MEDICARE
MN
Enumeration date
02/04/2006
Last updated
06/09/2026
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