Individual
JENNIFER DICKENSON MCGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1233 34TH ST NW, BEMIDJI, MN 56601-5112
(218) 333-5000
(406) 247-3389
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9419
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15142
MN
363A00000X
Physician Assistant
87236
MT
363AM0700X
Medical Physician Assistant
PA-1282
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27454240
—
NM
Enumeration date
01/29/2007
Last updated
12/26/2024
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