Provider Demographics
NPI:1336612969
Name:POJAH, JEREMIAH SK SR (RN)
Entity type:Individual
Prefix:MR
First Name:JEREMIAH
Middle Name:SK
Last Name:POJAH
Suffix:SR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5201 BRYANT AVENUE NORTH
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55430
Mailing Address - Country:US
Mailing Address - Phone:612-804-3278
Mailing Address - Fax:612-521-0830
Practice Address - Street 1:5201 BRYANT AVENUE NORTH
Practice Address - Street 2:SUITE 108
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55430
Practice Address - Country:US
Practice Address - Phone:612-804-3278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR142712-9163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse