HomeNPI Verification

NPI Verification

National Provider Identifier: 1538395496

Jacklyn Mae Ellickson, MD

Individual Provider

Credentials

Primary Specialty

Internal Medicine, Endocrinology, Diabetes & Metabolism

Code: 207RE0101X

All Specialties (2)

Internal Medicine, Endocrinology, Diabetes & Metabolism

Code: 207RE0101X

Internal Medicine, Endocrinology, Diabetes & Metabolism

Code: 207RE0101X

Primary

Practice Address

401 PHALEN BLVD

SAINT PAUL, MN 551305302

Phone: 651-254-7870

NPI Enumeration Date

June 5, 2009

NPI Number

1538395496

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry