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General NPI Number Information
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NPI Number | 1154729903
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Entity Type | Individual
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Provider Name | JENNA LEA BOOKLER MA, ATC, LAT, OTC
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Gender | Female
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Dates
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Enumeration Date | 12/10/2014
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 8100 NORTHLAND DR
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City | BLOOMINGTON
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State | MN
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Zip | 55431-4800
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Country | US
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Telephone | 952-831-8742
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Fax |
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Provider Business Mailing Address
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Address Line | 300 6TH AVE N
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City | SOUTH SAINT PAUL
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State | MN
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Zip | 55075-2044
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Country | US
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Telephone | 952-738-1285
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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 | 246ZX2200X
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Taxonomy Name | Orthopedic Assistant
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License Number | 19-0620
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 3103
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License Number State | MN
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