MR. JEREMY D NIETZ PA-C NPI 1780655472

NPI Information

NPI: 1780655472
Provider Name: MR. JEREMY D NIETZ, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
1 VETERANS DR
MINNEAPOLIS, MN
ZIP 55417
Phone: (612) 725-2000
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MR. Jeremy D Nietz, PA-C is a medical physician assistant in Minneapolis, MN. MR. Jeremy D Nietz, PA-C NPI is 1780655472. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1 VETERANS DR
MINNEAPOLIS, MN
ZIP 55417-309
Phone: (612) 725-2000

The enumeration date for this NPI number is 1/30/2006 and was last updated on 9/30/2010.

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
1	363AS0400X	Physician Assistant	Surgical	9489	MINNESOTA	No
2	363AM0700X	Physician Assistant	Medical	9489	MINNESOTA	Yes

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
1	P02705	MEDICARE UPIN	MINNESOTA
2	970000713	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA

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: 11/14/2023

NPI Synchronization or Removal

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