Individual
JENNIFER A FLAHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7100
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1874023
WI
363AS0400X
Surgical Physician Assistant
10917
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598746513
—
WI
05
—
42872100
—
WI
Enumeration date
11/08/2005
Last updated
12/05/2023
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