Provider Demographics
NPI:1750958674
Name:CONRATH, JAMIE KAY (DNP-PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:KAY
Last Name:CONRATH
Suffix:
Gender:F
Credentials:DNP-PMHNP-BC
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:KAY
Other - Last Name:PEARCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:613 9TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASECA
Mailing Address - State:MN
Mailing Address - Zip Code:56093
Mailing Address - Country:US
Mailing Address - Phone:507-461-6311
Mailing Address - Fax:
Practice Address - Street 1:124 ELTON HILLS LN NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901
Practice Address - Country:US
Practice Address - Phone:507-461-6311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-189516-2163W00000X
MN83922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No163W00000XNursing Service ProvidersRegistered Nurse