Provider Demographics
NPI:1699492124
Name:PAN, JANE HSIAOCHEN (SPEECH LANGUAGE PATH)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:HSIAOCHEN
Last Name:PAN
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 UNIVERSITY AVE SE APT 508
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3738
Mailing Address - Country:US
Mailing Address - Phone:503-200-7039
Mailing Address - Fax:
Practice Address - Street 1:2135 BIRMINGHAM ST
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-3511
Practice Address - Country:US
Practice Address - Phone:651-748-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1007110235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist