Provider Demographics
NPI:1831456532
Name:BJERKE, AJA AUTUMN (MD)
Entity type:Individual
Prefix:
First Name:AJA
Middle Name:AUTUMN
Last Name:BJERKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AJA
Other - Middle Name:AUTUMN
Other - Last Name:BJRZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 EAST LIBERTY STREET
Mailing Address - Street 2:SUITE 555
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501
Mailing Address - Country:US
Mailing Address - Phone:775-348-1900
Mailing Address - Fax:
Practice Address - Street 1:1 E LIBERTY ST STE 555
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-2104
Practice Address - Country:US
Practice Address - Phone:775-348-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16572208M00000X, 207L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program