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General NPI Number Information
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NPI Number | 1124420179
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Entity Type | Individual
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Provider Name | JENNA NIGGELER L.AC
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Gender | Female
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Dates
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Enumeration Date | 09/22/2014
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Last Update Date | 11/11/2019
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Provider Practice Location Address
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Address Line | 1001 KINGWOOD ST STE 119A
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City | BRAINERD
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State | MN
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Zip | 56401
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Country | US
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Telephone | 218-831-9190
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Fax |
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Provider Business Mailing Address
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Address Line | 14713 INGLEWOOD DR
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City | BAXTER
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State | MN
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Zip | 56425-8522
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Country | US
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Telephone | 218-831-9190
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 1746
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License Number State | MN
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