Individual
JENNIFER L SISELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1415 LILAC DR N STE 190, GOLDEN VALLEY, MN 55422-4544
(763) 267-8701
(763) 231-9602
Mailing address
1415 LILAC DR N STE 190, GOLDEN VALLEY, MN 55422-4544
(763) 267-8701
(763) 231-9602
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
6715
MN
Other
Enumeration date
07/29/2019
Last updated
11/11/2019
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