Provider Demographics
NPI:1437272317
Name:KESSLER, JODELL (MS)
Entity Type:Individual
Prefix:
First Name:JODELL
Middle Name:
Last Name:KESSLER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5123
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56302-5123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2835 W SAINT GERMAIN ST STE 300
Practice Address - Street 2:BOX 5123
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-6281
Practice Address - Country:US
Practice Address - Phone:320-255-1499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5520235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN115484OtherUCARE
MN411625495OtherUNITED HEALTH CARE
MN645133OtherPRO NET
MN4600206OtherMEDICA
MN7985172OtherAETNA
MN7G226KEOtherBLUE PLUS
MN9390635OtherLUMENOS
MN0411625495OtherFORTIS
MN01016518OtherPREFERRED ONE
MN4600206OtherSELECT CARE
MN7005573OtherPREFERRED ONE COMM HEALTH
MN904245800Medicaid
MN1880044OtherMAYO MANAGEMENT
MN7005573OtherPREFERRED ONE ADMIN SERV
MN7G226KEOtherBLUE CROSS BLUE SHIELD
MN7G226KEOtherBLUE LINK