Individual
MRS. JESSICA RIA BABCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11725 STINSON AVE, CHISAGO CITY, MN 55013-9542
(651) 257-8499
Mailing address
3008 GETTYSBURG AVE N, NEW HOPE, MN 55427-2307
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363A00000X
—
Other
Enumeration date
05/31/2011
Last updated
12/17/2012
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