Provider Demographics
NPI:1407393929
Name:JAMLING, DECHEN C (BSN RN)
Entity Type:Individual
Prefix:
First Name:DECHEN
Middle Name:C
Last Name:JAMLING
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7361 JACKSON ST NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-3208
Mailing Address - Country:US
Mailing Address - Phone:612-205-9075
Mailing Address - Fax:
Practice Address - Street 1:7361 JACKSON ST NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-3208
Practice Address - Country:US
Practice Address - Phone:612-205-9075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN204-785-4163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical