Slettedahl, John Edwin
Slettedahl, John Edwin is an individual health care provider with primary practice located at 400 E 3Rd St , Duluth MN 55805-1951. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Slettedahl, John Edwin can be contacted via phone (218) 786-8364.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R1336786 | Minnesota |
Profile Details
| NPI number | 1154380939 |
|---|---|
| LBN Legal business name | Slettedahl, John Edwin |
| Credentials | RN, CNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 21st, 2006 |
| Last updated | May 12th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154380939 | NPPES |
| Minnesota | MEDICAID | 1154380939 | |
| Minnesota | MEDICAID | 36090500 |
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