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NPI Code Detail

MEDICARE: JESSICA MARIE MOERTEL M.D.

MEDICARE: JESSICA MARIE MOERTEL M.D.
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
1207Q00000XFamily Medicine Physician59499MN

General Provider Information

NPI Number : 1669888905
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MARIE MOERTEL M.D.
Provider Business Mailing Address
First Line : 846 HIGH POINT DR NE
Second Line :
City : BYRON
State : MN
Zip : 55920-4407
Country : US
Telephone Number : 507-775-2128
Fax Number :
Provider Business Practice Location Address
First Line : 846 HIGH POINT DR NE
Second Line :
City : BYRON
State : MN
Zip : 55920-4407
Country : US
Telephone Number : 507-775-2128
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2014
Last Update Date : 01/30/2024

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Directions to “ JESSICA MARIE MOERTEL M.D.” Practice Location

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