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NPI Code Detail

MEDICARE: JACLYN ASHLEY ZABOLOTNY RN

MEDICARE: JACLYN ASHLEY ZABOLOTNY RN
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
1363LF0000XFamily Nurse Practitioner13951MN

General Provider Information

NPI Number : 1447064480
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACLYN ASHLEY ZABOLOTNY RN
Provider Business Mailing Address
First Line : 2222 LIBERTY GLEN LOOP
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56304-4683
Country : US
Telephone Number : 612-834-8473
Fax Number :
Provider Business Practice Location Address
First Line : 4801 VETERANS DR
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-2015
Country : US
Telephone Number : 320-252-1670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2025
Last Update Date : 05/20/2026

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