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NPI Code Detail

MEDICARE: JASELYN CATHERINE MCREAKEN DPT

MEDICARE: JASELYN CATHERINE MCREAKEN DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist13390MN

General Provider Information

NPI Number : 1154284495
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASELYN CATHERINE MCREAKEN DPT
Provider Business Mailing Address
First Line : PO BOX 860912
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55486-0912
Country : US
Telephone Number : 507-284-2511
Fax Number :
Provider Business Practice Location Address
First Line : 1000 1ST DR NW
Second Line :
City : AUSTIN
State : MN
Zip : 55912-2941
Country : US
Telephone Number : 507-668-2900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2025
Last Update Date : 02/04/2026

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