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General NPI Number Information
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NPI Number | 1003105289
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Entity Type | Individual
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Provider Name | JENNIFER ANN MINNEMAN MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2011
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 301 UNIVERSITY BLVD
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City | GALVESTON
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State | TX
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Zip | 77555-2936
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Country | US
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Telephone | 409-772-1011
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Fax | 409-772-4456
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Provider Business Mailing Address
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Address Line | PO BOX 23410
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City | LITTLE ROCK
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State | AR
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Zip | 72221-3410
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Country | US
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Telephone | 501-224-1690
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | R7820
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD60855907
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License Number State | WA
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