Healthcare Provider Details

I. General information

NPI: 1669456281
Provider Name (Legal Business Name): JANE MARIE HESS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANE HESS JASZEWSKI D.O.

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 12/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 W 66TH ST
RICHFIELD MN
55423-2203
US

IV. Provider business mailing address

790 W 66TH ST
RICHFIELD MN
55423-2203
US

V. Phone/Fax

Practice location:
  • Phone: 612-352-5800
  • Fax: 612-352-5990
Mailing address:
  • Phone: 612-352-5800
  • Fax: 612-352-5990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number33725
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: