Basic Information
| Provider Information | |||||||||
| NPI: | 1487736013 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EDDY | ||||||||
| FirstName: | JANCY | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | WHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 NICOLLET MALL | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554022500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123332503 | ||||||||
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| Practice Location | |||||||||
| Address1: | 801 NICOLLET MALL | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554022500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123332503 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2006 | ||||||||
| LastUpdateDate: | 05/16/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LX0001X | 114182-9 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 640042600 | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | HP31353 | 01 | MN | HEALTH PARTNERS | OTHER | 640042600 | 05 | MN | MEDICAID | 0703770 | 01 | MN | MEDICA CHOICE | OTHER | 172616D686 | 01 | MN | U-CARE | OTHER | 0700065 | 01 | MN | MEDICA DUAL/MEDICARE MA | OTHER | FP9041030948 | 01 | MN | PREFERRED ONE | OTHER | 876119 | 01 | MN | AMERICA'S PPO | OTHER |