Provider Demographics
NPI:1578842993
Name:UDY, JAMIE L (FNP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:UDY
Suffix:
Gender:F
Credentials:FNP
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Other - Credentials:
Mailing Address - Street 1:415 JEFFERSON ST NORTH
Mailing Address - Street 2:TRI-COUNTY HEALTH CARE
Mailing Address - City:WADENA
Mailing Address - State:MN
Mailing Address - Zip Code:56482-1296
Mailing Address - Country:US
Mailing Address - Phone:218-631-3510
Mailing Address - Fax:218-631-7507
Practice Address - Street 1:4 DEERWOOD AVE NW
Practice Address - Street 2:TRI-COUNTY HEALTH CARE WADENA CLINIC
Practice Address - City:WADENA
Practice Address - State:MN
Practice Address - Zip Code:56482-1296
Practice Address - Country:US
Practice Address - Phone:218-631-1360
Practice Address - Fax:218-631-7507
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2017-12-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MNCNP3246364SA2200X, 363LF0000X
MNR173384-2364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health