Healthcare Provider Details

I. General information

NPI: 1124088737
Provider Name (Legal Business Name): JENNIFER ANN TESSMER-TUCK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5709 LONG BRAKE TRL
EDINA MN
55439-2621
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-1000
US

V. Phone/Fax

Practice location:
  • Phone: 651-373-6097
  • Fax:
Mailing address:
  • Phone: 844-832-1956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number48068
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: