Provider Demographics
NPI:1295902740
Name:JERNEY, CAROLA ANDREA (MD)
Entity type:Individual
Prefix:
First Name:CAROLA
Middle Name:ANDREA
Last Name:JERNEY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MAIL STOP 21110Q
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1665 UTICA AVE S STE 100
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-3476
Practice Address - Country:US
Practice Address - Phone:952-541-2500
Practice Address - Fax:952-541-2539
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2021-06-11
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Provider Licenses
StateLicense IDTaxonomies
MN53584207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN080021006Medicare PIN