Individual
JESICA LANCETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1687 WOODLANE DR STE 208, WOODBURY, MN 55125-3047
(651) 327-0849
(651) 383-4557
Mailing address
1687 WOODLANE DR STE 208, WOODBURY, MN 55125-3047
(651) 327-0849
(651) 383-4557
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649815614
GROUP NPI
MN
Enumeration date
04/28/2021
Last updated
04/28/2021
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