Female

Jessica M. Staples PA-C

Physician Assistant in Fridley, MN(View on Map)

Full Name

Jessica M Staples PA-C

NPI Number

1356544274

NPI Type

Individual Provider

Gender

Female

Enumeration Date

06/07/2007

Specialties

(Taxonomies)

Code

363A00000X

Primary Taxonomy

Yes

Licenses

State

Minnesota

License Number

10271

Contact
Information

Purpose

Mailing
Location

Address

8290 UNIVERSITY AVE NE STE 200
8290 UNIVERSITY AVE NE STE 200

City

Fridley
Fridley

State

MN
MN

Postal Code

55432-1876
55432-1876

Country

US
US

Telephone Number

(763) 786-9543
(763) 786-9543

Identifiers

Identifier

1356544274

Identifier State

MN

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/02/2018

Provider Address

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