JEFFREY THOMAS WEIDEMAN (NPI# 1013149079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013149079 |
| Entity Type | Individual |
| Full Name | JEFFREY THOMAS WEIDEMAN |
| Credential | PA-C |
| Practice Address |
1901 Old Minnesota Ave Saint Peter MN 56082-1763 |
| Mailing Address |
1230 E Main St Po Box 8674 Mankato MN 56001-5066 |
| Practice Telephone | 5079342325 |
| Mailing Telephone | 5076251811 |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2020-07-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
10628 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1901 OLD MINNESOTA AVE |
| City | SAINT PETER |
| State | MN |
| Zip Code | 56082-1763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134107147 | Lon T Knudson | Pediatrics | 1901 Old Minnesota Ave, Mankato Clinic @ Daniels Health Center, Saint Peter, MN 56082-1763 | 2006-01-09 |
| 1104207174 | Kendra Lee Finn | Family Medicine | 1901 Old Minnesota Ave, Saint Peter, MN 56082-1763 | 2015-06-15 |
| 1952576126 | Mankato Clinic Ltd | Non-Pharmacy Dispensing Site | 1901 Old Minnesota Ave, Saint Peter, MN 56082-1763 | 2008-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295276079 | Ashley Jaspers | Nurse Practitioner | 1900 N. Sunrise Drive, Suite #200, St. Peter, MN 56082 | 2017-03-14 |
| 1841730876 | Go Therapy Inc | Speech-Language Pathologist | 830 Sunrise Dr Ste B, Saint Peter, MN 56082 | 2017-02-23 |
| 1487063210 | Ashley Krug | Specialist/Technologist | 800 West College Ave, Saint Peter, MN 56082 | 2014-08-06 |
| 1235578519 | Mikkel Dean Haugen | Dentist | 402 Sunrise Drive, St Peter, MN 56082 | 2013-06-19 |
| 1104163849 | House of Hope, Inc. | Community/Behavioral Health | 201 West Park Row, Suite B, Saint Peter, MN 56082 | 2013-01-15 |
| 1851579700 | Laura J. Hulsebus | Chiropractor | 206 West Walnut St, St Peter, MN 56082 | 2008-02-02 |
| 1588857072 | Michael Joseph Lange | Psychologist | 1703 Csah 15, St. Peter, MN 56082 | 2007-08-20 |
| 1235290420 | Andrew D. Lundquist | Podiatrist | 1901 Oid Minnesota Ave, Mankato Clinic @ Daniel's Health Center, St. Peter, MN 56082 | 2006-12-12 |
| 1962517037 | Mary A Snyder | Dentist | 202 W Walnut, St Peter, MN 56082 | 2006-08-20 |
| 1124041504 | Diane Ruth Bruder | Nurse Practitioner | 2000 Klein Street, St. Peter, MN 56082 | 2006-07-25 |
| Find all providers in zip 56082 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969150 | Isaac Waalen | Physician Assistant | 5420 Circle Down, Minneapolis, MN 55416-1312 | 2020-03-28 |
| 1730643701 | Christina Jones | Physician Assistant | 11850 Blackfoot St Nw Ste 270, Coon Rapids, MN 55433-2593 | 2019-01-24 |
| 1114492964 | Molly Goss | Physician Assistant | 1817 Sunset Dr, Northfield, MN 55057-3246 | 2018-10-09 |
| 1932600160 | Ellen Kathryn Freeman | Physician Assistant | 111 Hundertmark Rd Ste 480, Chaska, MN 55318-1485 | 2018-02-22 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1073051751 | Hannah Elizabeth Rosenthal Danielson | Physician Assistant | 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 | 2017-02-02 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1538545686 | Kathryn Jelle | Physician Assistant | 3931 Louisiana Ave S # 55426, St Louis Park, MN 55426-5000 | 2015-07-30 |
| 1831503267 | Karrah Oliver | Physician Assistant | 205 Roosevelt Ave W, Karlstad, MN 56732-4022 | 2014-06-13 |
| 1477981777 | Melissa Ferraz De Toledo | Physician Assistant | 9145 Springbrook Dr Nw Ste 300, Coon Rapids, MN 55433-5897 | 2013-10-23 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PETER |
| Zip Code | 56082 |
Please comment or provide details below to improve the information on JEFFREY THOMAS WEIDEMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.