Individual
JESSICA JERICH WETTERLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
435 PHALEN BLVD, MS 51103C, ST. PAUL, MN 55130
(651) 254-8500
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
(651) 254-8500
(651) 254-8504
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
1245529379
IL
208800000X
Urology Physician
4301112391
MI
208800000X
Urology Physician
Primary
66275
MN
Other
Enumeration date
03/29/2011
Last updated
07/21/2022
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