Provider Demographics
NPI:1174622294
Name:ONA, JACQUELINE C (MD)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:C
Last Name:ONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:615 S MILL ST
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2756
Mailing Address - Country:US
Mailing Address - Phone:218-739-2221
Mailing Address - Fax:218-739-5501
Practice Address - Street 1:615 S MILL ST
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2756
Practice Address - Country:US
Practice Address - Phone:218-739-2221
Practice Address - Fax:218-739-5501
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN44238207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN04-03927OtherMEDICA
MN1029622OtherPREFERREDONE
NE41091744413Medicaid
MN42M37ONOtherBCBS
MNHP35495OtherHEALTHPARTNERS
MN141528OtherUCAREMN
NE41091744413Medicaid