JERRY WAYNE STANKE M.D.
NPI 1043329220
Dermatology in Saint Paul, MN

Active since August 30, 2006
3555 WILLOW LAKE BLVD, SUITE 240, SAINT PAUL, MN 55110(651) 770-0110(651) 770-0134 Get Directions Write a Review

NPPES record last updated: January 28, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jerry Wayne Stanke M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY WAYNE STANKE M.D. (NPI 1043329220) is an individual dermatology provider in Saint Paul, Minnesota, licensed in Minnesota (22442) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1043329220
Entity TypeIndividualMale
Primary Taxonomy207N00000X
Provider Legal NameJERRY WAYNE STANKECredential: M.D.
Location Address3555 WILLOW LAKE BLVD, SUITE 240Saint Paul, MN 55110-5131
Mailing Address60 Plato Blvd E, Suite 270Saint Paul, MN 55107-1827 · (651) 209-1600 · Fax (651) 291-9169
Fax(651) 770-0134
Sole ProprietorNo
Enumeration DateAugust 30, 2006
Last NPPES UpdateJanuary 28, 2013
NPI 1043329220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in MN · 22442
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
3555 WILLOW LAKE BLVD, Saint Paul, MN 55110

Other Identifiers 2

Medicaid553002400MN
Medicare PIN070000086MN

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dermatology
3555 WILLOW LAKE BLVD, SUITE 240
VADNAIS HEIGHTS, MN 55110
Dermatology
3555 WILLOW LAKE BLVD, SUITE 240
SAINT PAUL, MN 55110
Dermatology (MOHS-Micrographic Surgery)
3555 WILLOW LAKE BLVD, SUITE 240
SAINT PAUL, MN 55110
Physician Assistant
3555 WILLOW LAKE BLVD
VADNAIS HEIGHTS, MN 55110
Dermatology
3555 WILLOW LAKE BLVD, SUITE 240
SAINT PAUL, MN 55110

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Stanke's NPI number?

The NPI number for Jerry Stanke is 1043329220. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Jerry Stanke located?

Jerry Stanke practices at 3555 Willow Lake Blvd Suite 240, Saint Paul, MN 55110. The listed phone number is (651) 770-0110.

What is Jerry Stanke's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

When was this NPI record last updated?

The NPPES record for Jerry Stanke was last updated on January 28, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.