Individual
JENNA M MINEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9000 W SURA LN, GREENFIELD, WI 53228-3477
(414) 647-3146
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4707-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100093866
—
WI
Enumeration date
06/25/2019
Last updated
10/13/2025
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