JACQUELINE VLIETSTRA NPI 1275905366

NPI Information

NPI: 1275905366
Provider Name: JACQUELINE VLIETSTRA
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
2265 COMO AVE
SAINT PAUL, MN
ZIP 55108
Phone: (651) 379-6100
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Jacqueline Vlietstra is a specialist in Saint Paul, MN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Jacqueline Vlietstra NPI is 1275905366. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2265 COMO AVE
SAINT PAUL, MN
ZIP 55108-737
Phone: (651) 379-6100

The enumeration date for this NPI number is 10/28/2015 and was last updated on 10/28/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		58551	MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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