Provider Demographics
NPI:1679334650
Name:DOTSETH, JENNIFER B (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:B
Last Name:DOTSETH
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 267
Mailing Address - Street 2:
Mailing Address - City:LESTER PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55354-0267
Mailing Address - Country:US
Mailing Address - Phone:320-626-4446
Mailing Address - Fax:320-238-7755
Practice Address - Street 1:12800 WHITEWATER DR STE 100
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9347
Practice Address - Country:US
Practice Address - Phone:320-626-4446
Practice Address - Fax:320-238-7755
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND200158363LP0808X
MN11200363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health