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General NPI Number Information
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NPI Number | 1790334043
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Entity Type | Individual
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Provider Name | JEFFREY CHARLES KESSLER DNP
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Gender | Male
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 4801 VETERANS DR
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City | SAINT CLOUD
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State | MN
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Zip | 56303
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Country | US
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Telephone | 406-860-0832
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Fax |
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Provider Business Mailing Address
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Address Line | 10535 33RD AVE N
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City | PLYMOUTH
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State | MN
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Zip | 55441-3122
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Country | US
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Telephone | 406-860-0832
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 6901
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License Number State | MN
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