Healthcare Provider Details

I. General information

NPI: 1740145366
Provider Name (Legal Business Name): JENNIFER RAE DEAN PCD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3255 78TH ST E
INVER GROVE HEIGHTS MN
55076-3033
US

IV. Provider business mailing address

3255 78TH ST E
INVER GROVE HEIGHTS MN
55076-3033
US

V. Phone/Fax

Practice location:
  • Phone: 651-235-4604
  • Fax:
Mailing address:
  • Phone: 651-235-4604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: