1558495192 NPI number — JANELL LYNN HOERNEMANN DC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558495192 NPI number — JANELL LYNN HOERNEMANN DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOERNEMANN
Provider First Name:
JANELL
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STIER
Provider Other First Name:
JANELL
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558495192
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
727 DELAWARE ST SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONSDALE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55046-8506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-744-4646
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 DIVISION STREET
Provider Second Line Business Practice Location Address:
NOBLE CHIROPRACTIC CLINIC PA
Provider Business Practice Location Address City Name:
NORTHFIELD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55057-2014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-645-8242
Provider Business Practice Location Address Fax Number:
804-645-8242
Provider Enumeration Date:
03/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  4039 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 121T4ST . This is a "COMP CARE SERVICES CCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 623838 . This is a "HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 121T4ST . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 623838 . This is a "AMERICAN CHIRO NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 623838 . This is a "MEDICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 623838 . This is a "UCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 623838 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0846 . This is a "PREFERRED ONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0846 . This is a "HEALTH SERVICES MGMT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0846 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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