| Doctor Name: | TWILA JESSO |
| NPI Number: | 1043552896 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | 188626-5 |
| Business Practice Address: | 43500 Migizi Dr Onamia, MN - 563592241 |
| Business Phone Number: | 3205324163 |
| Business Fax Number: | |
| Mailing Address: | 43500 Migizi Dr, ONAMIA |
| State: | MN |
| Postal Code: | 563592241 |
| Phone Number: | 3205324163 |
| Fax Number: | |
| NPI Enumeration Date: | 03/20/2013 |
| NPI Last Update Date: | 10/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0200X |
| License Number: | 188626-5 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |