Healthcare Provider Details

I. General information

NPI: 1447318316
Provider Name (Legal Business Name): JENNIFER LYNN HARRINGTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 02/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 CAMPUS DR SUITE 485
PLYMOUTH MN
55441-2676
US

IV. Provider business mailing address

750 S 2ND ST APT 502
MINNEAPOLIS MN
55401-2364
US

V. Phone/Fax

Practice location:
  • Phone: 651-290-7600
  • Fax: 763-413-7169
Mailing address:
  • Phone: 651-290-7600
  • Fax: 763-413-7169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number37988
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: