Individual
JESSICA M MONSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
1230 E MAIN ST, MANKATO CLINIC @ MAIN STREET, MANKATO, MN 56002-8674
(507) 625-1811
Mailing address
1230 E MAIN ST, PO BOX 8674, MANKATO, MN 56002-8674
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9771
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119474
MEDICA
MN
01
—
140K0DE
BCBS
MN
01
—
142816
UCARE
MN
01
—
1723094
AMERICAS PPO
MN
01
—
41084933956001C206
CHAMPUS
—
05
—
450072500
—
MN
01
—
HP36000
HEALTH PARTNERS
MN
01
—
NA2951032186
PREFERRED ONE
MN
01
—
P00106195
RR MEDICARE
—
Enumeration date
01/09/2006
Last updated
07/15/2020
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