Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 1087 | MN |
N | 213ES0103X | Foot & Ankle Surgery | DP174124 | OR |
NPI | 1073870192 |
---|---|
Provider Name | Dr. Kathryn C Jenewein |
First Address | Minneapolis, MN 55454-1450 |
Second Address | Fridley, MN 55432-4946 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2012 |
Last Update Date | 02/08/2021 |