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Jacqueline M Gustafson, CPNP
Pediatric Nurse Practitioner in Minneapolis, Minnesota
NPI 1760457527

Jacqueline M Gustafson is a Pediatric Nurse Practitioner based in Roseville, MN and is specialized in Pediatrics. Jacqueline M Gustafson practices in Minneapolis, MN and has the professional credentials of CPNP. The NPI Number for Jacqueline M Gustafson is 1760457527 and holds a License No. R1423754 (Minnesota).

The current practice location address for Jacqueline M Gustafson is 2525 Chicago Ave S, Minneapolis, MN and can be reached out via phone at 651-220-6446 and via fax at 651-220-6860.

Location: 2525 Chicago Ave S, Minneapolis, MN, 55113
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Provider Profile Details
NPI Number
1760457527
Provider Name
Jacqueline M Gustafson
Credential
CPNP
Provider Entity Type
Individual
Gender
Female
Address
2525 Chicago Ave S, Minneapolis, MN, 55113
Phone Number
651-220-6446
Fax Number
651-220-6860
Provider Enumeration Date
02/22/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
928198300 05 MN
institution
Provider Business Practice Location Address Details
Address
2525 Chicago Ave S
City
State
Zip
55404
Phone Number
651-220-6446
Fax Number
651-220-6860
person
Provider Business Mailing Address Details
Address
2525 Chicago Ave S
City
State
Zip
55404
Phone Number
651-220-6446
Fax Number
651-220-6860
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
R1423754 (Minnesota)
Definition
Definition to come...
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