Individual
JENNIFER OLDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
401 PHALEN BLVD - MS 41102A, HEALTHPARTNERS SPECIALTY CENTER 401, ST. PAUL, MN 55130-5302
(651) 254-7560
(651) 254-7564
Mailing address
8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 55425-4516
(952) 883-5375
(651) 254-7564
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
46816
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
701140700
—
MN
Enumeration date
05/15/2006
Last updated
12/01/2011
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