Individual
JACQUELINE SII
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1125 LAGOON AVE UNIT 528, MINNEAPOLIS, MN 55408-5156
(715) 697-4060
Mailing address
1125 LAGOON AVE UNIT 528, MINNEAPOLIS, MN 55408-5156
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MN
Other
Enumeration date
05/29/2026
Last updated
05/29/2026
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