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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JESSICA DEFORREST, MA, ATC

Active Sole Proprietor

JESSICA DEFORREST, MA, ATC is a Athletic Trainer healthcare provider located in ROBBINSDALE, Minnesota. NPI 1508133190 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · ROBBINSDALE, MN

Registration Details

NPI Number
1508133190
Provider Type
Individual
Gender
Female
NPI Issued
Nov 26, 2011 (14.723594903237 yrs)
Last Updated
Nov 26, 2011
License
1755 (MN)
Sole Proprietor
Yes

Practice Information

Address
4080 W BROADWAY AVE STE 300
ROBBINSDALE, MN, 554225607
Browse MN providers · Browse ZIP 55422
Phone
6512318379
Primary Specialty
Athletic Trainer
2255A2300X

Other Athletic Trainer Providers in ROBBINSDALE, MN

Name Credential NPI
REBECCA M STONE ATC 1588602817
MRS. LISA MARIE PARTYKA ATC 1033154695
SCOTT GREGORY GARDNER ATC 1063577880
MR. CHRISTOPHER NICHOLAS THEIN MS, ATC, EMT 1023137825
MR. SCOTT M WESTERMANN ATC 1588784862
MATTHEW STONEBERG MS, ATC 1760503346
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.