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NPI Code Detail

MEDICARE: JENNIFER MARIE LIEN AU.D.

MEDICARE: JENNIFER MARIE LIEN AU.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist8035MN

General Provider Information

NPI Number : 1215012943
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MARIE LIEN AU.D.
Provider Business Mailing Address
First Line : 1631 BEECHWOOD AVE
Second Line :
City : SAINT PAUL
State : MN
Zip : 55116-2409
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1250 W BROADWAY AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-2533
Country : US
Telephone Number : 612-668-5020
Fax Number : 612-668-5025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 01/20/2026

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