Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 2203740 | MN |
NPI | 1033746714 |
---|---|
Provider Name | Jennifer Voss |
First Address | Minneapolis, MN 55413-1761 |
Second Address | Minneapolis, MN 55413-1761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2020 |
Last Update Date | 24/03/2020 |