Individual
JESSICA DETERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
205 WABASHA ST S, SAINT PAUL, MN 55107-1805
(651) 293-8100
(651) 293-8100
Mailing address
PO BOX 1309-MAIL STOP 21110Q, MINNEAPOLIS, MN 55440-1309
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
6515
MN
Other
Enumeration date
06/10/2019
Last updated
08/09/2019
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