Provider Demographics
NPI:1720155294
Name:JURAS, JAMI (PA)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:
Last Name:JURAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S MAPLE ST
Mailing Address - Street 2:ATTN: MEDICAL STAFF OFFICE
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-1791
Mailing Address - Country:US
Mailing Address - Phone:952-442-2191
Mailing Address - Fax:952-442-8055
Practice Address - Street 1:916 SAINT PETER ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:MN
Practice Address - Zip Code:55328-2813
Practice Address - Country:US
Practice Address - Phone:952-442-7800
Practice Address - Fax:763-972-7234
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA15473363A00000X
MN12743363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant