1841267739 NPI number — JAMIE LYN MILLER REINSCHMIDT MD

Table of content: JAMIE LYN MILLER REINSCHMIDT MD (NPI 1841267739)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841267739 NPI number — JAMIE LYN MILLER REINSCHMIDT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REINSCHMIDT
Provider First Name:
JAMIE LYN
Provider Middle Name:
MILLER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
REINSCHMIDT
Provider Other First Name:
JAMIE
Provider Other Middle Name:
LYN MILLER
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841267739
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/15/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8170 33RD AVE S
Provider Second Line Business Mailing Address:
MS21110Q
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55425-4516
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2831 N SNELLING AVE - MAIL STOP 39601A
Provider Second Line Business Practice Location Address:
NORTH SURBURBAN FAMILY PHYSICIANS - ROSEVILLE
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55113-2460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-765-5900
Provider Business Practice Location Address Fax Number:
651-765-5901
Provider Enumeration Date:
03/01/2006

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: 207Q00000X , with the licence number:  38027 , 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: 399118100 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




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