Search › Minnesota › 363A00000X
Jennifer Idiculla, PA-C
NPI 1841661824 · on the registry since 2015
Practice
- Address
- 4300 Edgewood Dr Ne
Saint Michael, MN 55376 - Phone
- (763) 744-4000
- Clinicians at this address
- 12
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- MN
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-01-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota