Individual
JESSICA MARIE WITTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 442-1641
Mailing address
909 CURRY TRL, EAGAN, MN 55123-1983
(651) 442-1641
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
19415630
WI
163W00000X
Registered Nurse
R1882609
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
107493
MN
Other
Enumeration date
09/03/2015
Last updated
09/25/2015
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