Individual
JACKIE YANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
546 S ELM ST, WACONIA, MN 55387-1814
(651) 603-4565
Mailing address
546 S ELM ST, WACONIA, MN 55387-1814
(651) 603-4565
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6627
MN
Other
Enumeration date
08/25/2015
Last updated
08/29/2023
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