Agnes L. Jackai APRN, CNP, PMHNP-BC
Full Name
Agnes Limunga Jackai APRN, CNP, PMHNP-BC
NPI Number
1891403135
NPI Type
Individual Provider
Gender
Female
Enumeration Date
11/07/2022
Specialties
(Taxonomies)Licenses
State
Minnesota
License Number
PENDING
Contact
Information
Purpose
Mailing
Location
Address
12125 VERMILLION ST NE UNIT E
12125 VERMILLION ST NE UNIT E
City
Blaine
Blaine
State
MN
MN
Postal Code
55449-5678
55449-5678
Country
US
US
Telephone Number
(612) 598-3937
(612) 598-3937
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 03/22/2023