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JAN MARIE NICODEMUS
NPI 1659886448
Home Health Aide in Zimmerman, MN

Active since December 04, 2017
12950 FREMONT AVE STE 102, ZIMMERMAN, MN 55398(763) 294-0714(763) 374-7161 Get Directions Write a Review

NPPES record last updated: July 21, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2024, Nov 1, 2023, Jun 16, 2018 and 1 more (4 updates tracked since 2017).

About Jan Marie Nicodemus NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAN MARIE NICODEMUS (NPI 1659886448) is an individual home health aide in Zimmerman, Minnesota, licensed in Minnesota (10704477) and active in the NPI registry since December 2017. She maintains a secondary practice location in Ranchester.

NPPES Registry Identity

NPI1659886448
Entity TypeIndividualFemale
Primary Taxonomy374U00000X
Provider Legal NameJAN MARIE NICODEMUS
Location Address12950 FREMONT AVE STE 102Zimmerman, MN 55398-4629
Mailing Address12950 Fremont Ave Ste 102Zimmerman, MN 55398-4629 · (763) 294-0714 · Fax (763) 374-7161
Phone(763) 294-0714
Fax(763) 374-7161
Sole ProprietorNo
Enumeration DateDecember 4, 2017
Last NPPES UpdateJuly 21, 20244 updates tracked since enumeration
NPPES CertifiedJuly 21, 2024
✔ NPI 1659886448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome Health AideNursing Service Related Providers
Taxonomy Code374U00000X
License✔ Licensed in MN · 10704477
Definition

A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes.

12950 FREMONT AVE STE 102, Zimmerman, MN 55398
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Secondary Practice Location 1

Location 1155 Trail DrRanchester, WY 82839-5030 · Phone (763) 238-5215 · Fax (763) 374-7161

Other Identifiers 4

Other1083146344WY · Home Health Agency
Other1083146344MN · Pdn
Other1083146344MN · Home Health Agency
Other1083146344MN · Skilled Nursing

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COMPASSIONATE HOME CARE LTD
Home Health
12950 FREMONT AVE STE 102
ZIMMERMAN, MN 55398
Sherburne County (763) 238-5215
HOLLY BETH ZELENAK REGISTERED NURSE
Registered Nurse (Home Health)
12950 FREMONT AVE STE 102
ZIMMERMAN, MN 55398
Sherburne County (763) 294-0714

Frequently Asked Questions

What is Jan Nicodemus's NPI number?

The NPI number assigned to this healthcare provider is 1659886448, enumerated as an "individual" on December 04, 2017.

Where is the provider located?

The provider is located at 12950 FREMONT AVE STE 102 ZIMMERMAN, MN 55398 and the phone number is (763) 294-0714.

What is the provider's specialty?

Home Health Aide with taxonomy code 374U00000X.

What insurance does Jan Nicodemus accept?

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.