Provider Demographics
NPI:1487736013
Name:EDDY, JANCY ANN (WHNP-BC)
Entity type:Individual
Prefix:
First Name:JANCY
Middle Name:ANN
Last Name:EDDY
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 NICOLLET MALL
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-2500
Mailing Address - Country:US
Mailing Address - Phone:612-333-2503
Mailing Address - Fax:
Practice Address - Street 1:801 NICOLLET MALL
Practice Address - Street 2:SUITE 400
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2500
Practice Address - Country:US
Practice Address - Phone:612-333-2503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114182-9363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN640042600OtherBLUE CROSS BLUE SHIELD
MNHP31353OtherHEALTH PARTNERS
MN640042600Medicaid
MN0703770OtherMEDICA CHOICE
MN172616D686OtherU-CARE
MN0700065OtherMEDICA DUAL/MEDICARE MA
MNFP9041030948OtherPREFERRED ONE
MN876119OtherAMERICA'S PPO
MNP62408Medicare UPIN
MN0703770OtherMEDICA CHOICE