JAN MARIE NICODEMUS NPI 1659886448

NPI Information

  • NPI: 1659886448
  • Provider Name: JAN MARIE NICODEMUS
  • Classification: Home Health Aide - 374U00000X
  • Entity Type: Individual
  • Address: 12950 FREMONT AVE STE 102
    ZIMMERMAN, MN
    ZIP 55398
  • Phone: (763) 294-0714

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NPI Details

Jan Marie Nicodemus is a home health aide in Zimmerman, MN. The provider is a person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. Jan Marie Nicodemus NPI is 1659886448. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

12950 FREMONT AVE STE 102
ZIMMERMAN, MN
ZIP 55398-629
Phone: (763) 294-0714
Fax: (763) 374-7161

The enumeration date for this NPI number is 12/4/2017 and was last updated on 7/21/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1374U00000XHome Health Aide10704477MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11083146344OTHERWYOMINGHOME HEALTH AGENCY
21083146344OTHERMINNESOTAPDN
31083146344OTHERMINNESOTAHOME HEALTH AGENCY
41083146344OTHERMINNESOTASKILLED NURSING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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