Doctor Name: | JENNY K LESSMAN |
NPI Number: | 1205875598 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 10026 |
Business Practice Address: | 1245 Washington Ave S Detroit Lakes, MN - 56501 |
Business Phone Number: | 2188462000 |
Business Fax Number: | 2188462114 |
Mailing Address: | 1245 Washington Ave S, DETROIT LAKES |
State: | MN |
Postal Code: | 56501 |
Phone Number: | 2188462000 |
Fax Number: | 2188462114 |
NPI Enumeration Date: | 06/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 10026 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |