Provider Demographics
NPI:1487142253
Name:JERDE, ASHLEY EMMA (DC)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:EMMA
Last Name:JERDE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:EMMA
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:604 4TH ST SW
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376-9626
Mailing Address - Country:US
Mailing Address - Phone:612-247-0165
Mailing Address - Fax:763-757-4108
Practice Address - Street 1:11919 CENTRAL AVE NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-3911
Practice Address - Country:US
Practice Address - Phone:763-479-3388
Practice Address - Fax:763-757-4108
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor