MEDICARE: JENNA SOMMER TRUCKENBROD PA-C

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
1	363AM0700X	Medical Physician Assistant	1737	NE
2	363A00000X	Physician Assistant	1040	SD
3	363A00000X	Physician Assistant	1737	NE

General Provider Information

NPI Number	:	1942644521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA SOMMER TRUCKENBROD PA-C

Provider Business Mailing Address
First Line	:	211 SIOUX POINT RD STE 200
Second Line	:
City	:	DAKOTA DUNES
State	:	SD
Zip	:	57049-5492
Country	:	US
Telephone Number	:	605-370-7823
Fax Number	:	605-422-3001

Provider Business Practice Location Address
First Line	:	211 SIOUX POINT RD STE 200
Second Line	:
City	:	DAKOTA DUNES
State	:	SD
Zip	:	57049-5492
Country	:	US
Telephone Number	:	605-422-3000
Fax Number	:	605-422-3001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2013
Last Update Date	:	03/12/2026

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Directions to “ JENNA SOMMER TRUCKENBROD PA-C” Practice Location

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