Individual
MRS. DEANNA LATOYA JASPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11011 JEFFERSON ST NE, BLAINE, MN 55434-2826
(763) 862-9093
(763) 755-0217
Mailing address
11011 JEFFERSON ST NE, BLAINE, MN 55434-2826
(763) 862-9093
(763) 755-0217
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
471049469
—
MN
Enumeration date
12/16/2014
Last updated
12/16/2014
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