Individual
JESSICA ANNE FASHANT-PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
6452 CITY WEST PKWY, EDEN PRAIRIE, MN 55344-3245
(952) 999-0333
(952) 300-2558
Mailing address
6452 CITY WEST PARKWAY, EDEN PRAIRIE, MN 55344
(952) 999-0333
(952) 300-2558
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R161940-3
MN
Other
Enumeration date
09/17/2009
Last updated
05/22/2017
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