Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JENNIFER POETHKE IDICULLA, PA-C
ActiveJENNIFER POETHKE IDICULLA, PA-C is a Physician Assistant healthcare provider located in SAINT MICHAEL, Minnesota. NPI 1841661824 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · SAINT MICHAEL, MN
Registration Details
- NPI Number
- 1841661824
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 15, 2015 (10.683927787397 yrs)
- Last Updated
- Jan 12, 2023
- License
-
1289 (MN)
Practice Information
- Address
-
4300 EDGEWOOD DR NESAINT MICHAEL, MN, 553764588Browse MN providers · Browse ZIP 55376
- Phone
- 7637444000
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in SAINT MICHAEL, MN
| Name | Credential | NPI |
|---|---|---|
| EMILY ALLISON DANIELSON | PA-C | 1356776272 |
| MRS. EMILY JO WALKER | P.A.-C. | 1184092785 |
| MATTHEW DENNES MCKEEVER | PA-C | 1841957982 |
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.