Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 46591 | MN |
N | 207QS0010X | Family Doctor - Sports Medicine | 46591 | MN |
NPI | 1336120971 |
---|---|
Provider Name | Becky Jo Mueller |
First Address | Becker, MN 55308-8838 |
Second Address | Becker, MN 55308-8838 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 16/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0121080 | MEDICA HEALTH PLANS (01) | |
0121081 | MEDICA HEALTH PLANS (01) | |
0121082 | MEDICA HEALTH PLANS (01) | |
1043957 | PREFERRED ONE (01) | |
135113 | U CARE (01) | |
2366395 | ARAZ GROUP AMERICAS PPO (01) | |
550K4MU | BLUE CROSS BLUE SHIELD (01) | |
819660500 | MEDICAL ASSISTANCE (01) | |
H86450 | (02) | |
HP53208 | HEALTH PARTNERS (01) |