JERILYN MARIE WIEDERHOLT (NPI# 1962691501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962691501 |
| Entity Type | Individual |
| Full Name | JERILYN MARIE WIEDERHOLT |
| Credential | PSYCHOLOGIST |
| Practice Address |
801 Highway 3 N Suite 101 Northfield MN 55057-9401 |
| Mailing Address |
209 Spring St N Northfield MN 55057-1432 |
| Practice Telephone | 5073212002 |
| Mailing Telephone | 5076454687 |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3079 | MN | Behavioral Health & Social Service Providers |
| Street Address |
801 HIGHWAY 3 N SUITE 101 |
| City | NORTHFIELD |
| State | MN |
| Zip Code | 55057-9401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831750322 | Rebecca Brooks Amundson | Marriage & Family Therapist | 570 Professional Drive, Northfield, MN 55057 | 2019-06-25 |
| 1639734635 | Benedictine Living Community of Northfield, LLC | Assisted Living Facility | 2030 North Avenue, Northfield, MN 55057 | 2019-05-06 |
| 1053798637 | Kevin Cassin | Optometrist | 2019 Jefferson Rd Ste A, Northfield, MN 55057 | 2015-05-02 |
| 1538446059 | Salwa Bakkali Derksen | Hospitalist | 2000 N Avenue, Northfield, MN 55057 | 2011-11-11 |
| 1689804783 | Angela Lynn Burt | Occupational Therapist | 815 Forest Ave., Three Links Care Center, Northfield, MN 55057 | 2009-07-23 |
| 1659519106 | Heidi Lee Auge | Physical Therapist | 805 Forest Avenue, Three Links Care Center-therapy, Northfield, MN 55057 | 2009-01-21 |
| 1639326689 | Tina Swenson | Speech-Language Pathologist | 1 Northfield, Northfield, MN 55057 | 2008-08-21 |
| 1356567739 | Eric Allen Cram | Chiropractor | 158 Water St. N, Suite 2, Northfield, MN 55057 | 2007-04-17 |
| 1407072689 | Justine Faye Politz | Nurse Practitioner | Northfield Hopital, 2000 N. Ave., Northfield, MN 55057 | 2007-04-17 |
| 1518080399 | John Jacques Hilo | Chiropractor | 158 Water St. N., Suite 2, Northfield, MN 55057 | 2007-04-09 |
| Find all providers in zip 55057 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386251148 | Andrew Charles Weis | Psychologist | 158 Water St N Ste 1, Northfield, MN 55057-2125 | 2020-09-25 |
| 1881241586 | Shannon Maura Tassava | Psychologist | 1716 Sunset Dr, Northfield, MN 55057-3237 | 2019-08-19 |
| 1679031231 | Michael Dale Seiler | Psychologist | 778 W Frontage Rd Ste 111, Northfield, IL 60093-1209 | 2019-03-03 |
| 1134684939 | Jennifer Harris Psyd, LLC | Psychologist | 550 W Frontage Rd Ste 2797, Northfield, IL 60093-1238 | 2019-02-05 |
| 1134662042 | Elizabeth Kathryn Hossfeld | Psychologist | 191 Waukegan Rd Ste 208, Northfield, IL 60093-2743 | 2016-11-24 |
| 1407288079 | Meryl Pankhurst | Psychologist | 465 N Central Ave, Suite 201, Northfield, IL 60093-3015 | 2013-08-06 |
| 1124300470 | Joseph W. Byrne | Psychologist | 456 W Frontage Rd Ste 232, Northfield, IL 60093-3034 | 2011-09-13 |
| 1831409317 | The Arnold Center for Integrated Wellness, P.C. | Psychologist | 456 W. Frontage Rd., Suite 32, Northfield, IL 60093 | 2010-10-18 |
| 1073840484 | Barry M Leavitt and Associates | Psychologist | 790 Frontage Rd, Northfield, IL 60093-1204 | 2009-11-05 |
| 1346415015 | Lloyd Thomas Cunningham | Psychologist | 456 W. Frontage Rd. Suite 32, Northfield, IL 60093 | 2008-04-24 |
| Find all providers in NORTHFIELD | ||||
| City | NORTHFIELD |
| Zip Code | 55057 |
Please comment or provide details below to improve the information on JERILYN MARIE WIEDERHOLT.
| 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.