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General NPI Number Information
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NPI Number | 1073870192
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Entity Type | Individual
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Provider Name | KATHRYN C JENEWEIN DPM
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Gender | Female
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 6625 LYNDALE AVE S STE 105
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City | RICHFIELD
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State | MN
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Zip | 55423-2673
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Country | US
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Telephone | 612-788-8778
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Fax |
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Provider Business Mailing Address
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Address Line | 2450 RIVERSIDE AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55454-1450
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Country | US
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Telephone | 612-672-7510
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Fax | 612-672-4123
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DP174124
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 1087
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License Number State | MN
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