Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 51803 | MN |
Y | 208600000X | Surgeon | 51803 | MN |
N | 208200000X | Surgeon | 65389-20 | WI |
N | 208600000X | Surgeon | 65389-20 | WI |
NPI | 1013151430 |
---|---|
Provider Name | Jennifer Ann Cameron |
First Address | Saint Paul, MN 55102-2383 |
Second Address | Saint Paul, MN 55102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2009 |
Last Update Date | 31/05/2018 |