Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 29227 | MN |
NPI | 1023012812 |
---|---|
Provider Name | Jody Kay Hargrove |
First Address | Edina, MN 55435-5924 |
Second Address | Edina, MN 55435 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 18/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105766C477 | UCARE (01) | MN |
24766 | AMERICA'S PPO (01) | MN |
31558890 | (05) | MN |
3217002 | MEDICA (01) | MN |
411774839A005 | CHAMPUS (01) | MN |
660003748 | RR MEDICARE (01) | MN |
66Q41HA | BLUE CROSS BLUE SHIELD (01) | MN |
960080401007 | PREFERRED ONE (01) | MN |
E06736 | (02) | MN |
HP13471 | HEALTHPARTNERS (01) | MN |