Provider Demographics
NPI:1154531192
Name:GRAJCZYK, JESSICA L (DO)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:L
Last Name:GRAJCZYK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6405 FRANCE AVE S STE W400
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2165
Mailing Address - Country:US
Mailing Address - Phone:952-920-2730
Mailing Address - Fax:952-567-7090
Practice Address - Street 1:6405 FRANCE AVE. SOUTH
Practice Address - Street 2:SUITE W400
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2192
Practice Address - Country:US
Practice Address - Phone:952-920-2730
Practice Address - Fax:952-567-7090
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN51920207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology