Thom, Jean

Thom, Jean is an individual health care provider with primary practice located at 1601 Golf Course Rd , Grand Rapids MN 55744-8648. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Thom, Jean can be contacted via phone (218) 326-5000.

Contact Information

Primary practice address
1601 Golf Course Rd Grand Rapids MN 55744-8648
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 169566-22 Minnesota

Profile Details

NPI number 1598743494
LBN Legal business name Thom, Jean
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2006
Last updated Feb 21st, 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 1598743494 NPPES
Minnesota MEDICAID 913542100

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