Provider Demographics
NPI:1093845679
Name:GETCHIUS, JACQUELINE SUZANNE DENISON (BA)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:SUZANNE DENISON
Last Name:GETCHIUS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 GALLAGHER DR
Mailing Address - Street 2:APT. 304
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4527
Mailing Address - Country:US
Mailing Address - Phone:612-743-6471
Mailing Address - Fax:
Practice Address - Street 1:1133 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-2629
Practice Address - Country:US
Practice Address - Phone:651-641-0177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program