Individual
JEREMY PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN, PHN
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Mailing address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2465042
MN
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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