Idziorek, Pamela J

Idziorek, Pamela J is an sole proprietor health care provider with primary practice located at 4891 Miller Trunk Hwy , Hermantown MN 55811-1512. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Idziorek, Pamela J can be contacted via phone (218) 626-1222.

Contact Information

Primary practice address
4891 Miller Trunk Hwy Hermantown MN 55811-1512
Phone: (218) 626-1222
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R077946-7 Minnesota

Profile Details

NPI number 1134235344
LBN Legal business name Idziorek, Pamela J
Credentials RNNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 21st, 2006
Last updated Sep 16th, 2013 - about 13 years 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 1134235344 NPPES
Minnesota Other 8G561ID BCBS
Minnesota MEDICAID 192225400 BCBS
Minnesota Other 8G560ID BCBS

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