Individual
JENNIFER M PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP, GNP
Contact information
Practice address
800 E 28TH ST, SUITE H2100, MINNEAPOLIS, MN 55407-3723
(612) 863-3900
(612) 863-1681
Mailing address
PO BOX 43, MR 10809, MINNEAPOLIS, MN 55440-0043
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R1542350
MN
363LG0600X
Gerontology Nurse Practitioner
R1542350
MN
Other
Enumeration date
08/31/2006
Last updated
08/20/2009
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