Eidem, Jori L

Eidem, Jori L is an individual health care provider with primary practice located at 132 17Th Ave Nw , Rochester MN 55901-0321. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Eidem, Jori L can be contacted via phone (507) 292-7411.

Contact Information

Primary practice address
132 17Th Ave Nw Rochester MN 55901-0321
Phone: (507) 292-7411
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9884 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1967-023 Wisconsin

Profile Details

NPI number 1235101171
LBN Legal business name Eidem, Jori L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 4th, 2006
Last updated Jun 9th, 2026 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235101171 NPPES
Minnesota MEDICAID ENROLLED
Minnesota Other P00996318
Minnesota MEDICAID 824682300

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