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Individual

JESSICA LEE TOMLIN BRUNFELT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(651) 982-7600
Mailing address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(651) 982-7600

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R 147155-7
MN
363LF0000X
Family Nurse Practitioner
Primary
R 147155-7
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-06279
MEDICA PRIMARY
MN
01
01-19710
MEDICA CHOICE
MN
01
0590695
IA MA
IA
01
1042813
PREFERRED ONE
MN
01
132544
UCARE
MN
01
2293216
ARAZ
MN
05
403132600
MN
05
41254200
WI
05
4304547
MT
01
459R7TO
BCBS
MN
01
HP48876
HEALTHPARTNERS
MN
Enumeration date
06/23/2006
Last updated
05/12/2014
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