Individual
JACQUELINE SHERRY OLCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9055 SPRINGBROOK DR NW, COON RAPIDS, MN 55433-5841
(763) 780-9155
Mailing address
2925 CHICAGO AVE, MR 10809, MINNEAPOLIS, MN 55407-1321
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39401
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
777825200
—
MN
Enumeration date
04/03/2006
Last updated
07/16/2024
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