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NPI Code Detail

MEDICARE: JANE KRISTIINA PANNING

MEDICARE: JANE KRISTIINA PANNING
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1831056787
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE KRISTIINA PANNING
Provider Business Mailing Address
First Line : 17420 32ND AVE N
Second Line :
City : PLYMOUTH
State : MN
Zip : 55447-1262
Country : US
Telephone Number : 763-516-1735
Fax Number :
Provider Business Practice Location Address
First Line : 1250 W BROADWAY AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-2533
Country : US
Telephone Number : 612-668-0254
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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