Individual
CONNIE JO A CALDWELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
640 JACKSON ST, MC 11102H, ST PAUL, MN 55101-2502
(651) 254-3462
(651) 254-1603
Mailing address
900 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6122
(715) 717-4121
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8980
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
857010800
—
MN
Enumeration date
02/15/2006
Last updated
12/18/2018
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