Ellickson, Jacklyn Mae
Ellickson, Jacklyn Mae is an individual health care provider with primary practice located at 401 Phalen Blvd , Saint Paul MN 55130-5302. She recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as her primary health care specialty. Ellickson, Jacklyn Mae can be contacted via phone (651) 254-7870.Contact Information
Primary practice address
401 Phalen Blvd
Saint Paul MN 55130-5302
Phone: (651) 254-7870
Fax: (651) 254-7876
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | 62721-20 | Wisconsin |
| Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | 53921 | Minnesota |
Profile Details
| NPI number | 1538395496 |
|---|---|
| LBN Legal business name | Ellickson, Jacklyn Mae |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 5th, 2009 |
| Last updated | Mar 17th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Popular Providers
-
Pitukweerakul, Siwadon
401 Phalen Blvd , Saint Paul MN 55130-5302 -
Sangtian, Jutarat
401 Phalen Blvd , Saint Paul MN 55130-5302 -
Mucha, Gregory T
401 Phalen Blvd , Saint Paul MN 55130-5302 -
Kaur, Jasleen
401 Phalen Blvd , Saint Paul MN 55130-5302 -
Benedict, Luke E
255 Smith Ave N Suite 100, Saint Paul MN 55102-2572 -
Patel, Sarang
401 Phalen Blvd , Saint Paul MN 55130-5302 -
Acharya, Nisha
225 Smith Ave N Ste 300 , Saint Paul MN 55102 -
Kalogeropoulou, Dionysia
401 Phalen Blvd , Saint Paul MN 55130-5302