Individual
JACQUELINE POLIPNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1301 33RD ST S, ST CLOUD, MN 56301
(320) 251-8181
(320) 251-6942
Mailing address
251 COUNTY ROAD 120, SAINT CLOUD, MN 56303-4872
(320) 202-8949
(320) 202-0756
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10000
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332113400
—
MN
Enumeration date
06/29/2006
Last updated
03/30/2023
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