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Individual

JODINE L JANZEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
120 1ST AVE E, CAMBRIDGE, MN 55008-1209
(763) 689-1494
(763) 691-8395
Mailing address
120 1ST AVE E, CAMBRIDGE, MN 55008-1209
(763) 689-1494
(763) 691-8395

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
2586
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1014827
PREFERRED ONE
MN
01
2201810
MEDICA
MN
05
321025100
MN
01
410047970
RAILROAD MEDICARE
MN
01
64G67JA
BLUECROSS BLUESHIELD
MN
Enumeration date
09/14/2005
Last updated
02/04/2010
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