Jessica Rose Malterud, BSN, PHN, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2088651 Issued in MN

Practice address

416-2ND Street NW
Cass Lake, MN 56633

Phone

(218) 335-8868

NPI assigned

Sep 10, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1205485430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30502 360TH ST",
            "city": "LAPORTE",
            "state": "MN",
            "postal_code": "564614043",
            "telephone_number": "218-760-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416-2ND STREET NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56633",
            "telephone_number": "218-335-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALTERUD",
        "first_name": "JESSICA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "BSN, PHN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2088651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ladonna Therese Lock, PHARMD
• Oluwasikemi A Lotsu, PHARM.D
• Loretta Jean Lynne, RN
• Birdena M Lyons, LPN
• Duane Malterud, DNP
• Constance J Mangiamele, APRN
• Rachel Marie Markham
• Roberta L Marsolek, RN
• Lindsey Renee Marvel, O.D.
• Alissa Massie, DPT

• Registered Nurse in Cass Lake, MN
• Providers in Cass Lake, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.