Individual
JAN MARIE NICODEMUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12950 FREMONT AVE STE 102, ZIMMERMAN, MN 55398-4629
(763) 294-0714
(763) 374-7161
Mailing address
12950 FREMONT AVE STE 102, ZIMMERMAN, MN 55398-4629
(763) 294-0714
(763) 374-7161
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
10704477
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083146344
PDN
MN
01
—
1083146344
HOME HEALTH AGENCY
WY
Enumeration date
12/04/2017
Last updated
07/21/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us