Individual
JILLIAN C CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2090 WOODWINDS DR, WOODBURY, MN 55125-2522
(651) 968-5801
(651) 968-5899
Mailing address
710 COMMERCE DR STE 200, WOODBURY, MN 55125-4925
(651) 968-5042
(651) 968-5904
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10785
MN
363AS0400X
Surgical Physician Assistant
Primary
10785
MN
Other
Enumeration date
08/25/2010
Last updated
07/05/2022
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