Provider Demographics
NPI:1518942580
Name:ESSELMAN, JENNIFER LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:ESSELMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:ESPESETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:9125 QUADAY AVE NE
Mailing Address - Street 2:STE 102
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330-6662
Mailing Address - Country:US
Mailing Address - Phone:763-274-0373
Mailing Address - Fax:763-274-0375
Practice Address - Street 1:9125 QUADAY AVE NE
Practice Address - Street 2:STE 102
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-6662
Practice Address - Country:US
Practice Address - Phone:763-274-0373
Practice Address - Fax:763-274-0375
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4280111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350003555Medicaid
MNV07982Medicare UPIN
MN350003555Medicaid