Jacqueline Sue Pal, C-NP
Individual provider Active NPI Nurse Practitioner · North Oaks, MN
NPI 1023200490 · NPPES record last updated Aug 9, 2007
Key facts
- NPI
- 1023200490
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- R 147242-0 (MN)
- Practice address
- 400 Village Center Dr Ste 800
North Oaks, MN 55127-7201 - Phone
- (651) 276-8346
- Fax
- (651) 765-8351
- NPI assigned
- Aug 9, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 147242-0 | MN | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R 147242-0 | MN | Yes |
Addresses
Primary practice location
400 Village Center Dr Ste 800
North Oaks, MN 55127-7201
Mailing address
400 Village Center Dr Ste 800
North Oaks, MN 55127-7201
Phone (651) 276-8346
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R 147242-0 | Other | MN | MN STATE NURSING LICENSE |
Other providers in North Oaks, MN
- Yasin Farah Mohamed
- Momenta, PC
- Kristin Neafus
- Thomas Erik Neafus
- North Metro Dermatology PLLC
- Marilynn Poss
- Presbyterian Homes of North Oaks Inc,
- Presbyterian Homes of North Oaks, Inc.
- Prime Chiropractic & Rehab Center
- Prime Family Medical Clinic
All providers in North Oaks, MN · Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.