Healthcare Provider Details
I. General information
NPI: 1871483131
Provider Name (Legal Business Name): JENNA KATHRYN SIEFKEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/08/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4229 W FRONTAGE RD N
ROCHESTER MN
55901-4310
US
IV. Provider business mailing address
PO BOX 149
SYRACUSE NE
68446-0149
US
V. Phone/Fax
- Phone: 507-322-3460
- Fax: 507-322-3450
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 14104 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: