Basic Information
| Provider Information | |||||||||
| NPI: | 1659463990 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOMMERDING | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13 W SHORE RD | ||||||||
| Address2: | |||||||||
| City: | NORTH OAKS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551276451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6514831132 | ||||||||
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| Practice Location | |||||||||
| Address1: | 69 EXCHANGE ST W | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551021004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512323000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 363L00000X | R084546-4 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.