NPI 1053088245
Dorothy Lee Jenicke, STUDENT
Practice location
- Address
- 8053 E Bloomington Fwy, Bloomington, MN 55420-4577
- Phone
- (612) 333-2155
- Mailing address
- 946 Hawthorne Ave E, Saint Paul, MN 55106-2012
Registered specialties
Student in an Organized Health Care Education/Training Program
Primary
Registry record
- NPI
- 1053088245
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 25 Aug 2021
- Record last updated
- 13 Nov 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.