Individual
JENNIFER ELAINE TRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6545 FRANCE AVE S STE 210, EDINA, MN 55435-2281
(952) 928-2900
(952) 928-2944
Mailing address
2550 UNIVERSITY AVE W STE 110N, SAINT PAUL, MN 55114-2001
(651) 602-5309
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
12200
MN
363AS0400X
Surgical Physician Assistant
Primary
12200
MN
Other
Enumeration date
09/12/2016
Last updated
01/30/2023
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