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NPI Code Detail

MEDICARE: AYLA JANE JURCHISIN LIMBERG PHYSICIAN ASSISTANT

MEDICARE: AYLA JANE JURCHISIN LIMBERG PHYSICIAN ASSISTANT
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
1363A00000XPhysician Assistant12344MN
2363A00000XPhysician Assistant8902-23WI

General Provider Information

NPI Number : 1528510872
Entity Type Code : Individual
Provider Name (Legal Business Name) : AYLA JANE JURCHISIN LIMBERG PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : 2829 UNIVERSITY AVE SE STE 730
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55414-3279
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 333 SMITH AVE N
Second Line :
City : SAINT PAUL
State : MN
Zip : 55102-2344
Country : US
Telephone Number : 612-863-6590
Fax Number : 612-863-5247
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2016
Last Update Date : 06/02/2026

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