Individual
JENNIFER ANN LENIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2430 E MASON ST, GREEN BAY, WI 54302-3759
(920) 406-9863
Mailing address
2430 E MASON ST, GREEN BAY, WI 54302-3759
(920) 406-9863
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2006
WI
363AS0400X
Surgical Physician Assistant
2006
WI
Other
Enumeration date
09/03/2006
Last updated
01/26/2012
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