Provider Demographics
NPI:1134261597
Name:LOUREY, JENNIFER ANDREA (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANDREA
Last Name:LOUREY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 IVY AVE SE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MN
Mailing Address - Zip Code:56368-4509
Mailing Address - Country:US
Mailing Address - Phone:320-321-0166
Mailing Address - Fax:320-321-0167
Practice Address - Street 1:307 IVY AVE SE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MN
Practice Address - Zip Code:56368-4509
Practice Address - Country:US
Practice Address - Phone:320-597-8999
Practice Address - Fax:320-597-8995
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN299171100000X
MN003166111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN31G10HEOtherBCBS
MN647220600OtherMEDICAL ASSISTANCE
MN411508205OtherAETNA & SIGNA PREFERRED O
MN31G09SPOtherBCBS
MN411973450OtherWC, PI, UCARE, MEDICA
MN350049912OtherRAILROAD MEDICARE
MN1016069OtherHEALTH SERVICE MANAGEMENT
MN350049912OtherRAILROAD MEDICARE
MN411973450OtherWC, PI, UCARE, MEDICA