Active NPI
Barbara Jezorski
- Registered Nurse
- Arden Hills, MN
National Provider Identifier
1376959924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R 124770-7
- Practice address
- 3900 Northwoods Dr Ste 240
Arden Hills, MN 55112-6991 - Phone
- (651) 633-7300
- Fax
- (651) 633-7301
- NPI assigned
- Jul 3, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R 124770-7 | MN | Primary |
Addresses
Primary practice location
3900 Northwoods Dr Ste 240
Arden Hills, MN 55112-6991
Mailing address
4360 McDonald Drive CT N
Stillwater, MN 55082-2126
Phone (651) 270-1589
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 124770-7 | MN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1376959924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4360 MCDONALD DRIVE CT N",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550822126",
"telephone_number": "651-270-1589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 NORTHWOODS DR STE 240",
"city": "ARDEN HILLS",
"state": "MN",
"postal_code": "551126991",
"telephone_number": "651-633-7300",
"fax_number": "651-633-7301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEZORSKI",
"first_name": "BARBARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-03",
"last_updated": "2024-07-22",
"certification_date": "2024-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "R 124770-7",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arden Hills, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.