Provider Demographics
NPI: | 1679528079 |
---|---|
Name: | HOXMEIER, JAMI (PHD, LP) |
Entity type: | Individual |
Prefix: | DR |
First Name: | JAMI |
Middle Name: | |
Last Name: | HOXMEIER |
Suffix: | |
Gender: | F |
Credentials: | PHD, LP |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 3800 HIGHWAY 52 N STE 220 |
Mailing Address - Street 2: | |
Mailing Address - City: | ROCHESTER |
Mailing Address - State: | MN |
Mailing Address - Zip Code: | 55901-5825 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 507-923-7321 |
Mailing Address - Fax: | 507-540-1285 |
Practice Address - Street 1: | 3800 HIGHWAY 52 N STE 220 |
Practice Address - Street 2: | |
Practice Address - City: | ROCHESTER |
Practice Address - State: | MN |
Practice Address - Zip Code: | 55901-5825 |
Practice Address - Country: | US |
Practice Address - Phone: | 507-923-7321 |
Practice Address - Fax: | 507-540-1285 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-05-23 |
Last Update Date: | 2023-02-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MN | LP4471 | 103TC0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
1040168 | Other | PREFERRED ONE | |
136191 | Other | U-CARE | |
360R1H0 | Other | BX/BS | |
855661040168 | Other | PREFERREDONE ADMINISTRATI | |
MN | 926487600 | Medicaid | |
136191 | Other | U-CARE |