Basic Information
| Provider Information | |||||||||
| NPI: | 1831456532 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BJERKE | ||||||||
| FirstName: | AJA | ||||||||
| MiddleName: | AUTUMN | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | BJRZ | ||||||||
| OtherFirstName: | AJA | ||||||||
| OtherMiddleName: | AUTUMN | ||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1 EAST LIBERTY STREET | ||||||||
| Address2: | SUITE 555 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753481900 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1 E LIBERTY ST STE 555 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895012104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753481900 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2012 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 16572 | NV | N | Allopathic & Osteopathic Physicians | Hospitalist | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207L00000X | 16572 | NV | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.