Individual
DR. JANE M CHURCHILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 PLEASANT AVE S, PARK RAPIDS, MN 56470-1431
(218) 732-3311
(218) 732-1368
Mailing address
17833 COUNTY RD 40, PARK RAPIDS, MN 56470
(218) 732-9453
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18982
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
667368600
—
MN
Enumeration date
07/20/2006
Last updated
05/20/2010
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