Active NPI
Jessica Lynn Fettig-Logan, RN
- Community Health Registered Nurse
- Alexandria, MN
National Provider Identifier
1376779447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Registered Nurse
- License
- R 162188-6
- Practice address
- 725 Elm St
Suite 1200
Alexandria, MN 56308-1760 - Phone
- (320) 763-6018
- Fax
- (320) 763-4127
- NPI assigned
- Jun 3, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | R 162188-6 | MN | Primary |
Addresses
Primary practice location
725 Elm St
Suite 1200
Alexandria, MN 56308-1760
Mailing address
725 Elm St
Suite 1200
Alexandria, MN 56308-1760
Phone (320) 763-6018
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 162188-6 | MN | MD | Community Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Douglas | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community Based Hospice Care Agency
- Alexandria, MN
- NPI 1689677478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243987200000",
"number": "1376779447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 ELM ST",
"address_2": "SUITE 1200",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563081760",
"telephone_number": "320-763-6018",
"fax_number": "320-763-4127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 ELM ST",
"address_2": "SUITE 1200",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563081760",
"telephone_number": "320-763-6018",
"fax_number": "320-763-4127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETTIG-LOGAN",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-03",
"last_updated": "2009-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "MN",
"license": "R 162188-6",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.