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Individual

JAMIE OTREMBA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.N.M.

Contact information

Practice address
550 S MAPLE ST, WACONIA, MN 55387-1763
(952) 442-2137
(952) 442-5960
Mailing address
550 S MAPLE ST, WACONIA, MN 55387-1763
(952) 442-2137
(952) 442-5960

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
R131949-9
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
507488600
MN
Enumeration date
10/10/2005
Last updated
08/14/2007
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