Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JENNIFER SUSAN ELLIS, PA-C
ActivePhysician Assistant · WOODBURY, MN
Registration Details
- NPI Number
- 1013986611
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 16, 2006 (20.0992479989 yrs)
- Last Updated
- Sep 25, 2020
- Licenses
-
9602 (MN)9602 (MN)
Practice Information
- Address
-
4040 RADIO DRWOODBURY, MN, 551293237Browse MN providers · Browse ZIP 55129
- Phone
- 6514398807
- Fax
- 6514390232
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in WOODBURY, MN
| Name | Credential | NPI |
|---|---|---|
| TODD JERAMIE HOLTER | PAC | 1396742896 |
| MRS. JODI LYN BAUMGARTNER | PA-C | 1689668303 |
| CHRISTOPHER WILLIAM DUESMAN | PA-C | 1750379103 |
| KENNETH ALLEN MITCHELL | PA-C | 1922096379 |
| MS. EUNICE LEE | PA | 1053301036 |
| DARREL L COTCH | PA | 1164495016 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.