Individual provider · Type 1 NPI

Jeanine Marie Edstrom, PAC

Surgical Physician Assistant · Eagan, MN

NPI number 1447560693 Active

Practice location

1185 Town Centre Dr Ste 200
Eagan, MN 55123-1343

Call (612) 871-1145 Map

Fax (612) 870-5491

Mailing address

PO Box 14909
Minneapolis, MN 55414-0909

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X1504 (MN)

Surgical Physician Assistant: Definition to come...

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About NPI 1447560693

Jeanine Marie Edstrom, PAC's National Provider Identifier is 1447560693, issued on Oct 20, 2010. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Eagan, MN. The record was last updated on Mar 20, 2013.