Individual
JODI ANN WIECZOREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGCNS-BC, A.P.R.N.
Contact information
Practice address
201 E NICOLLET BLVD, BURNSVILLE, MN 55337-5714
(952) 892-2000
Mailing address
552 RED OAK CT, EAGAN, MN 55121-2335
(651) 402-8993
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
R 118342-1 CNS 0516
MN
Other
Enumeration date
11/11/2016
Last updated
11/11/2016
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