Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 57268 | MN |
Y | 2080P0205X | Pediatric Endocrinologist | 57268 | MN |
NPI | 1063464766 |
---|---|
Provider Name | Jennifer J Mcvean |
First Address | Minneapolis, MN 55454-1450 |
Second Address | Minneapolis, MN 55454-1404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 08/08/2017 |