Provider Demographics
NPI:1205165834
Name:HANSEN-BARNETT, JESSICA MORIA (DC, FASA)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MORIA
Last Name:HANSEN-BARNETT
Suffix:
Gender:F
Credentials:DC, FASA
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:MORIA
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC, FASA
Mailing Address - Street 1:201 N BROAD ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3585
Mailing Address - Country:US
Mailing Address - Phone:507-382-4997
Mailing Address - Fax:800-819-8339
Practice Address - Street 1:201 N BROAD ST
Practice Address - Street 2:SUITE 302
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3585
Practice Address - Country:US
Practice Address - Phone:507-382-4997
Practice Address - Fax:800-819-8339
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNPENDING111N00000X
MN5305111N00000X
MN874171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist