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Dorothy Lee Jenicke, STUDENT
Student in an Organized Health Care Education/Training Program in Prior Lake, Minnesota
NPI 1053088245

Dorothy Lee Jenicke is a Student in an Organized Health Care Education/Training Program based in Saint Paul, MN. Dorothy Lee Jenicke practices in Prior Lake, MN and has the professional credentials of STUDENT. The NPI Number for Dorothy Lee Jenicke is 1053088245 and holds a License No. (Minnesota).

The current practice location address for Dorothy Lee Jenicke is 16180 Hastings Ave Se, Prior Lake, MN and can be reached out via phone at 952-443-4600 and via fax at 952-443-4604.

Location: 16180 Hastings Ave Se, Prior Lake, MN, 55106-2012
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053088245
Provider Name
Dorothy Lee Jenicke
Credential
STUDENT
Provider Entity Type
Individual
Gender
Female
Address
16180 Hastings Ave Se, Prior Lake, MN, 55106-2012
Phone Number
952-443-4600
Fax Number
952-443-4604
Provider Enumeration Date
08/25/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
16180 Hastings Ave Se
City
Prior Lake
State
Minnesota
Zip
55372-9227
Phone Number
952-443-4600
Fax Number
952-443-4604
person
Provider Business Mailing Address Details
Address
16180 Hastings Ave Se
City
Prior Lake
State
Minnesota
Zip
55372-9227
Phone Number
952-443-4600
Fax Number
952-443-4604
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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