Provider Demographics
NPI:1891129425
Name:JAEGER, MARY ELIZABETH (RN, DNP, PCNS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH
Last Name:JAEGER
Suffix:
Gender:F
Credentials:RN, DNP, PCNS
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Mailing Address - Street 1:345 SMITH AVE N
Mailing Address - Street 2:MAILSTOP 70-504
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2346
Mailing Address - Country:US
Mailing Address - Phone:651-220-6444
Mailing Address - Fax:651-220-7233
Practice Address - Street 1:6625 LYNDALE AVE S STE 300
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2491
Practice Address - Country:US
Practice Address - Phone:612-788-8778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN2013012486364SP0200X
MN104364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics