Individual
JESSICA NOWACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(763) 607-7673
Mailing address
10925 NASSAU CT NE, BLAINE, MN 55449-5508
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2522614
MN
Other
Enumeration date
02/21/2025
Last updated
02/21/2025
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