Individual provider · Type 1 NPI

Jennifer Poethke Idiculla, PA-C

Physician Assistant · St. Michael, MN

NPI number 1841661824 Active

Practice location

4300 Edgewood Dr NE
St. Michael, MN 55376-4588

Call (763) 744-4000 Map

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X1289 (MN)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1841661824

Jennifer Poethke Idiculla, PA-C's National Provider Identifier is 1841661824, issued on Oct 15, 2015. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in St. Michael, MN. The record was last updated on Jan 12, 2023.