Provider Demographics
NPI:1568572840
Name:JESCH, KARRIE JO (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KARRIE
Middle Name:JO
Last Name:JESCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3463 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4315
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-467-2000
Practice Address - Fax:612-725-2149
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN9968363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical