NPI 1396861217 · live from the CMS NPI Registry
Jodell E Dahl, RN, MS, CNP
Nurse Practitioner, Pediatrics in Minneapolis, MN. National Provider Identifier 1396861217, active.
NPI record
| NPI | 1396861217 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 2450 Riverside Ave Se, East Building Journey Clinic 9e, Minneapolis, MN 55454 |
| Practice phone | 612-365-8100 |
| Mailing address | 202 Oak Grove Place, St. Paul, MN 55105 |
| Enumerated | March 22, 2007 |
| Last updated | April 11, 2012 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | R0866590 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.