Organization
GENOVATIONS REGEN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYNN ERGANG NP (OWNER)
(210) 630-0146
Entity
Organization
Contact information
Practice address
2228 JAMES ST, EAGAN, MN 55122-2336
(210) 630-0146
Mailing address
2228 JAMES ST, EAGAN, MN 55122-2336
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
02/08/2022
Last updated
02/15/2022
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