Ms Jessica Rae Tichy, AUD | |
1101 9th St N, Virginia, MN 55792-2329 | |
(218) 305-0000 | |
Not Available |
Full Name | Ms Jessica Rae Tichy |
---|---|
Gender | Female |
Speciality | Audiologist |
Location | 1101 9th St N, Virginia, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053197988 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
231H00000X | Audiologist | 528434 (Minnesota) | Primary |
Provider Name | The Duluth Clinic Ltd |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1902563638 PECOS PAC ID: 2567374283 Enrollment ID: O20031103000229 |
Mailing Address | Practice Location Address |
---|---|
Ms Jessica Rae Tichy, AUD 400 E 3rd St, Duluth, MN 55805-1951 Ph: (218) 786-8364 | Ms Jessica Rae Tichy, AUD 1101 9th St N, Virginia, MN 55792-2329 Ph: (218) 305-0000 |
Dr. Amy Katherine Rothermel, AU.D. Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1101 9th St N, Virginia, MN 55792 Phone: 218-741-0150 | |
Kathleen Jacklen, CCC/AUD Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1101 9th St N, Virginia, MN 55792 Phone: 218-741-0150 | |
Kelsey N Fairbanks, AUD Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1101 9th St N, Virginia, MN 55792 Phone: 218-305-0000 | |
Michael John Fridgen, Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1101 9th St N, Virginia, MN 55792 Phone: 218-741-0150 |