Individual
JENNIFER EVELYN PAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, PMHNP-BC
Contact information
Practice address
4027 COUNTY ROAD 25, MINNEAPOLIS, MN 55416-2629
(612) 925-6033
(612) 925-8496
Mailing address
4240 PARK GLEN RD, ST LOUIS PARK, MN 55416-5427
(612) 925-6033
(612) 925-8496
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2076278
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7441
MN
Other
Enumeration date
06/03/2020
Last updated
10/23/2023
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