Merryn R Jolkovsky
Internist Nephrologist Hospice and Palliative Medicine
1200 Sixth Ave N Centracare Clinic
St Cloud
, Minnesota 56303-2735
Merryn R Jolkovsky
Internist Nephrologist Hospice and Palliative Medicine
1200 Sixth Ave N Centracare Clinic
St Cloud
, Minnesota 56303-2735
(320) 240-2118
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About
Features
Specialties
- Internist
- Hospice and Palliative Medicine
- Nephrologist
Languages spoken
- English
Location
First Address
- Merryn R Jolkovsky
- 1200 Sixth Ave N Centracare Clinic
- St Cloud, MN
- Zip : 56303-2735
- Fax : (320) 240-2118
- Phone : (320) 252-5131
Second Address
- Merryn R Jolkovsky
- 1200 Sixth Ave N Centracare Clinic
- St Cloud, MN
- Zip : 56303-2735
- Fax : (320) 240-2118
- Phone : (320) 252-5131
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | 38835 | MN |
| N | 111NI0900X | Internist | 38835 | MN |
| Y | 207RH0002X | Hospice and Palliative Medicine | 38835 | MN |
| N | 207RN0300X | Nephrologist | 38835 | MN |
National Provider Identifier
| NPI | 1346231867 |
|---|---|
| Provider Name | Merryn R Jolkovsky |
| First Address | St Cloud, MN 56303-2735 |
| Second Address | St Cloud, MN 56303-2735 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/11/2005 |
| Last Update Date | 24/03/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1011481 | PREFERRED ONE (01) | |
| 110126975 | RR MEDICARE (01) | |
| 112147 | UCARE (01) | |
| 1616743 | FIRST HEALTH PLAN (01) | |
| 30T90JO | BLUE CROSS BLUE SHIELD (01) | |
| 3100291 (PL) | MEDICA HEALTH PLANS (01) | |
| 3107424 | MEDICA HEALTH PLANS (01) | |
| 600884 | ARAZ GROUP AMERICAS PPO (01) | |
| 926318700 | MEDICAL ASSISTANCE (01) | |
| BR1009643 | DEA (01) | |
| E17120 | (02) | |
| HP25459 | HEALTH PARTNERS (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.