MEDICARE: JESSICA ANN PALOZOLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	18640	WI
2	183500000X	Pharmacist	122995	MN

General Provider Information

NPI Number	:	1558976746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA ANN PALOZOLA

Provider Business Mailing Address
First Line	:	920 W 42ND ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55409-1411
Country	:	US
Telephone Number	:	920-809-0553
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 LARPENTEUR AVE W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55113-6317
Country	:	US
Telephone Number	:	651-488-5516
Fax Number	:	651-487-0990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2020
Last Update Date	:	09/14/2020

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Directions to “ JESSICA ANN PALOZOLA ” Practice Location

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