Jennifer Pederson

Primary specialty

Emergency Registered NurseTaxonomy code 163WE0003X

License

2367204 Issued in MN

Practice address

1630 Atwater Path
Inver Grove Heights, MN 55077-1200

Phone

(316) 619-2096

NPI assigned

Sep 6, 2019

Last updated

Sep 6, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1679122246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 ATWATER PATH",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550771200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 ATWATER PATH",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550771200",
            "telephone_number": "316-619-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "MN",
            "license": "2367204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Parthum
• Pathway Health Solutions LLC (Pathway Health Solutions)
• Paula Sadee LLC
• Sarah Jo Pavek, M.A.,L.P.
• PDG, P.a. (Park Dental)
• Pediatric Therapy Options, LLC
• Joshua William Peiffer
• Sochenda Pen
• Penny Lane Homes
• Carrie Buerman Peroutka, DDS

• Emergency Registered Nurse in Inver Grove Heights, MN
• Providers in Inver Grove Heights, MN by specialty
• Emergency Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.