Provider Demographics
NPI:1477261121
Name:JAUS, MARIAH MARIE (DNP, CNP, FNP-C)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:MARIE
Last Name:JAUS
Suffix:
Gender:F
Credentials:DNP, CNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14255 JACOB ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:MN
Mailing Address - Zip Code:55339-9444
Mailing Address - Country:US
Mailing Address - Phone:952-451-9078
Mailing Address - Fax:
Practice Address - Street 1:660 3RD ST
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MN
Practice Address - Zip Code:55334-2297
Practice Address - Country:US
Practice Address - Phone:507-237-5523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9576363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily