Individual
JACQUELINE OTTERSTATTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14000 FAIRVIEW DR, BURNSVILLE, MN 55337-5713
(952) 993-8700
Mailing address
2410 DOWNING AVE, SHAKOPEE, MN 55379-4544
(612) 709-8126
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2490796
MN
Other
Enumeration date
05/20/2025
Last updated
05/20/2025
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