Individual
MS. JESSICA L. WIDMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, MPAS, PA-C
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10636
MN
363AM0700X
Medical Physician Assistant
10636
MN
363AM0700X
Medical Physician Assistant
PA05147
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00829989
RAILROAD MEDICARE
MN
Enumeration date
02/09/2007
Last updated
04/09/2018
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