Provider Demographics
NPI:1629746466
Name:THONACK, JESSICA CHEN (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:CHEN
Last Name:THONACK
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3001 METRO DR STE 460
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1548
Mailing Address - Country:US
Mailing Address - Phone:763-520-7700
Mailing Address - Fax:833-905-2110
Practice Address - Street 1:3366 OAKDALE AVE N STE 303
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2977
Practice Address - Country:US
Practice Address - Phone:763-520-7700
Practice Address - Fax:833-905-2110
Is Sole Proprietor?:No
Enumeration Date:2021-09-04
Last Update Date:2023-09-28
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant