Individual
MRS. JENIFER KAREN DETERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
CENTRAL MINNESOTA EMERGENCY PHYSICIANS, 1406 6TH AVENUE NORTH, ST CLOUD, MN 56303-1901
(320) 255-5656
(320) 656-7044
Mailing address
9808 JENNY LN, SAINT JOSEPH, MN 56374-9692
(320) 363-1150
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9545
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9545
STATE REGISTRATION NUMBER
MN
Enumeration date
01/09/2007
Last updated
08/28/2007
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