Individual
JODI L BANGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 365-8100
Mailing address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 365-8100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MN
Other
Enumeration date
11/16/2011
Last updated
09/03/2025
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