Jenna Bottila, DPT
Individual provider Active NPI Physical Therapist · Hermantown, MN
NPI 1902748833 · NPPES record last updated Apr 8, 2026
Key facts
- NPI
- 1902748833
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 17346-24 (WI)
- Practice address
- 5050 Maple Grove Rd
Hermantown, MN 55811-1444 - Phone
- (218) 780-0042
- NPI assigned
- Apr 8, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17346-24 | WI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 17346-24 | WI | Yes |
Addresses
Primary practice location
5050 Maple Grove Rd
Hermantown, MN 55811-1444
Mailing address
5050 Maple Grove Rd
Hermantown, MN 55811-1444
Other names
- Jenna Fossell
Other providers in Hermantown, MN
- Emily Mae Bergstedt
- Bio-Medical Applications of Minnesota, Inc.
- April Dawn Bissonette
- Joannah Bluntach
- Skylar Mae Boe
- Paige Katherine Boyer
- Jason A Brandt
- April Lyn Brannan
- Tori A Brantal
- Aurora Marais Breidenbach
All providers in Hermantown, MN · Physical Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.