Provider Demographics
NPI:1093692691
Name:JESSEN-OLSON, JENNIFER
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:JESSEN-OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37494 QUINLAN AVE
Mailing Address - Street 2:
Mailing Address - City:TAYLORS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:55084-1779
Mailing Address - Country:US
Mailing Address - Phone:612-275-5863
Mailing Address - Fax:
Practice Address - Street 1:37494 QUINLAN AVE
Practice Address - Street 2:
Practice Address - City:TAYLORS FALLS
Practice Address - State:MN
Practice Address - Zip Code:55084-1779
Practice Address - Country:US
Practice Address - Phone:612-275-5863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13243363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner