MEDICARE: DR. JESSICA WARREN D.C.

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	111N00000X	Chiropractor	6217	MN

General Provider Information

NPI Number	:	1215382767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA WARREN D.C.

Provider Business Mailing Address
First Line	:	801 NW 9TH ST
Second Line	:
City	:	GRAND RAPIDS
State	:	MN
Zip	:	55744-2337
Country	:	US
Telephone Number	:	218-301-6074
Fax Number	:

Provider Business Practice Location Address
First Line	:	10150 CITY WALK DR APT F
Second Line	:
City	:	WOODBURY
State	:	MN
Zip	:	55129-9270
Country	:	US
Telephone Number	:	651-232-6830
Fax Number	:

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

Provider Enumeration Date	:	05/03/2016
Last Update Date	:	12/05/2025

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