1114170099 NPI number — MS. JANET AGNES HUTTON SENJEM M.S.S.W.

Table of content: MS. JANET AGNES HUTTON SENJEM M.S.S.W. (NPI 1114170099)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114170099 NPI number — MS. JANET AGNES HUTTON SENJEM M.S.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUTTON SENJEM
Provider First Name:
JANET
Provider Middle Name:
AGNES
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114170099
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 1ST.AVE.N.E.
Provider Second Line Business Mailing Address:
SUITE 217
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55906
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-281-5928
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 1ST AVE NE STE 217
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55906-4170
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-281-5928
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  06700 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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