Most Relevant Information
Provider Data
| NPI Number: | 1003548256 |
| Provider Name: | JEREMY LECLAIRE |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 9266 |
Most Important Dates
| Enumeration Date: | 06/27/2022 |
| Last Updated: | 06/27/2022 |
Provider Practice Location
303 E NICOLLET BLVD
BURNSVILLE
MN
553374522
Practice Location Phone/Fax
| Phone: | 9524604000 |
| Fax: |
Provider Mailing Location
6670 131ST ST W
APPLE VALLEY
MN
551244104
Provider Mailing Phone/Fax
| Phone: | 9526936285 |
| Fax: |