Individual
KATHRYN JELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3931 LOUISIANA AVE S # 55426, ST LOUIS PARK, MN 55426-5000
(952) 993-3248
Mailing address
3931 LOUISIANA AVE S # 55426, ST LOUIS PARK, MN 55426-5000
(952) 993-3248
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
11839
MN
Other
Enumeration date
07/30/2015
Last updated
07/30/2015
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