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Individual
JESSICA A. EDELMANN
Active
Individual
JESSICA A. EDELMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10413-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111200
SECURITY HEALTH PLAN
WI
05
—
40452300
—
WI
01
—
484R6ED
GROUP HEALTH/BCBS OF MN
WI
01
—
P00281530
RAILROAD MEDICARE
WI
Enumeration date
07/25/2006
Last updated
07/10/2007
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