Individual
JEANNE L WITTROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15290 PENNOCK LN - MAIL STOP 32200A, HEALTH PARTNERS APPLE VALLEY CLINIC, APPLE VALLEY, MN 55124-7163
(952) 431-8500
(952) 431-6966
Mailing address
8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 55425-4516
(952) 883-5375
(952) 431-6966
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29437
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151788100
—
MN
Enumeration date
02/02/2006
Last updated
11/30/2011
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