Provider Demographics
NPI:1386738995
Name:WYMAN, JEAN F (NP)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:F
Last Name:WYMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE ST SE MMC292
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:763-782-6400
Mailing Address - Fax:763-782-9558
Practice Address - Street 1:DEPT OF OB/GYN & WOMEN'S HEALTH
Practice Address - Street 2:420 DELAWARE STREET SE MMC 395
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:763-782-6400
Practice Address - Fax:763-782-9558
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR 138190-6363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN04-08300OtherMEDICA - CHOICE
MNB612OtherCHAMPUS
MN502K7WYOtherBCBS
MN04-04568OtherMEDICA - PRIMARY
MNHP27464OtherHEALTHPARTNERS
MN2378192OtherARAZ
WI41262700Medicaid
IA0715078Medicaid
MN1019243OtherPREFERRED ONE
MN123361OtherUCARE
MT4305977Medicaid
MN84536-2OtherFAIRVIEW CAREGIVE
MT4305977Medicaid