Provider Demographics
NPI:1407545742
Name:GIEGIERCH, JAECY LYNNE
Entity Type:Individual
Prefix:
First Name:JAECY
Middle Name:LYNNE
Last Name:GIEGIERCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9046 GLENBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:MN
Mailing Address - Zip Code:55020-9725
Mailing Address - Country:US
Mailing Address - Phone:612-805-8361
Mailing Address - Fax:
Practice Address - Street 1:333 SMITH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2344
Practice Address - Country:US
Practice Address - Phone:651-241-8290
Practice Address - Fax:651-241-7177
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist