Individual
MS. JACLYN ANN KOSTECKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2014 S 6TH ST, BRAINERD, MN 56401-4529
(218) 829-7812
Mailing address
10516 GULL POINT RD, EAST GULL LAKE, MN 56401-3281
(320) 828-0972
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/28/2020
Last updated
12/06/2022
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