Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MN |
NPI | 1114596772 |
---|---|
Provider Name | Jessica L Kesterson |
First Address | Saint Paul, MN 55105-3014 |
Second Address | Saint Paul, MN 55105-3014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2021 |
Last Update Date | 18/06/2021 |