Individual
MRS. JESSICA JAYNE ARCHBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2828 CHICAGO AVE, MINNEAPOLIS, MN 55407-1573
(612) 871-7639
Mailing address
512 W 53RD ST, MINNEAPOLIS, MN 55419-1225
(602) 501-0358
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
221051-3
MN
163W00000X
Registered Nurse
RN0000178937
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
103434
TN
Other
Enumeration date
08/03/2014
Last updated
10/06/2014
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