Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 5222 | MN |
N | 2086S0127X | Trauma Surgeon | 5222 | MN |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 5222 | MN |
N | 363LA2100X | Nurse Practitioner - Acute Care | 5222 | MN |
NPI | 1174990089 |
---|---|
Provider Name | Jennilyn Gunn |
First Address | Robbinsdale, MN 55422 |
Second Address | Robbinsdale, MN 55422-2926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2015 |
Last Update Date | 10/10/2021 |