NPI 1013986611

Jennifer Susan Ellis, PAC

Practitioner Physician Assistant Woodbury, MN

Practice location

Address: 4040 Radio Dr, Woodbury, MN 55129-3237
Phone: (651) 439-8807
Fax: (651) 439-0232
Mailing address: 4200 Dahlberg Dr STE 300, Golden Valley, MN 55422-4841

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 9602 (MN)

Other Physician Assistant providers in Minnesota →

Surgical Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence 9602 (MN)

Registry record

NPI: 1013986611
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Mar 2006
Record last updated: 25 Sep 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.