Individual
AMY MARGARET JANISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
6401 FRANCE AVE S, EDINA, MN 55435-2104
(612) 708-1143
Mailing address
6401 FRANCE AVE S, EDINA, MN 55435-2104
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R1443336
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
727668100
—
MN
Enumeration date
05/19/2006
Last updated
05/16/2008
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