Individual
JESSICA POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
927 TRETTEL LN, CLOQUET, MN 55720-1345
(218) 879-1227
Mailing address
927 TRETTEL LN, CLOQUET, MN 55720-1345
(218) 879-1227
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12124
MN
Other
Enumeration date
06/20/2016
Last updated
07/30/2020
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