Individual
JESSICA MAE MUDGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 E MAIN ST, CROSBY, MN 56441-1645
(218) 546-7000
Mailing address
12668 43RD AVE SW, PILLAGER, MN 56473-2405
(218) 839-1484
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F06181406
MN
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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