Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 60965 | MN |
NPI | 1316265499 |
---|---|
Provider Name | Jennifer Kay Wozniczka |
First Address | St Louis Park, MN 55426-5000 |
Second Address | St Louis Park, MN 55426-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2010 |
Last Update Date | 17/12/2018 |