Jacqueline M Gustafson
CPNP | Nurse Practitioner - Pediatrics
2525 Chicago Ave S, Childrens Specialty Clinic Feeding Clinic Mpls, Minneapolis
Minnesota, 55404
651-220-6446
Jacqueline M Gustafson is a Minneapolis, Minnesota based nurse practitioner who is specialized as Pediatrics nurse. Active license number of Jacqueline M Gustafson is R1423754 for Pediatrics in Minnesota. Her current practice location is 2525 Chicago Ave S, Childrens Specialty Clinic Feeding Clinic Mpls, Minneapolis. Patients can reach her at 651-220-6446 or can fax her at 651-220-6860. Jacqueline M Gustafson is CPNP with specialization in Pediatrics and her NPI number (Unique professional ID assigned by NPPES) is 1760457527.
Jacqueline M Gustafson specializes in caring for newborns, infants, toddlers, adolescents and young adults. She perform pediatric health care maintenance, including well child exams, developmental screenings and in-depth physical assessments, such as vision, hearing and dental. Pediatrics Nurse Practitioner (PNP) focus on well-child care and the prevention or management of common pediatric acute illnesses and chronic conditions.
Complete Profile:
Jacqueline M Gustafson speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Jacqueline M Gustafson |
| Specialization: | Pediatrics Nurse Practitioner (PNP) |
| Gender: | Female |
| Credentials: | CPNP |
| Practice Address: | 2525 Chicago Ave S, Childrens Specialty Clinic Feeding Clinic Mpls, Minneapolis,
Minnesota, 55404 |
| Phone: | 651-220-6446 |
| Fax: | 651-220-6860 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1760457527 |
| NPI Enumeration Date: | 22 Feb, 2006 |
| NPI Last Update On: | 10 Aug, 2015 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jacqueline M Gustafson are as mentioned below.
| License Number | Specialization | State | Status | |
| R1423754 | Pediatrics | Minnesota | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Jacqueline M Gustafson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 928198300 | Medicaid | Minnesota | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Jacqueline M Gustafson
2910 Centre Pointe Dr, 35-121a Childrens Health Care
Roseville, Minnesota |
| Zip: | 55113 |
| Phone Number: | 651-855-2109 |
| Fax Number: | 651-855-2310 |
Patients can reach Jacqueline M Gustafson at
2525 Chicago Ave S, Childrens Specialty Clinic Feeding Clinic Mpls, Minneapolis, Minnesota or can
call to book an appointment on 651-220-6446.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.