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General NPI Number Information
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NPI Number | 1174633184
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Entity Type | Individual
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Provider Name | JENNIFER C HSIA MD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 4365 PHEASANT RIDGE DR NE STE 106
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City | BLAINE
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State | MN
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Zip | 55449-4544
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Country | US
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Telephone | 888-938-3838
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Fax | 888-919-1083
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Provider Business Mailing Address
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Address Line | 10001 W INNOVATION DR STE 200
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City | MILWAUKEE
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State | WI
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Zip | 53226-4851
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Country | US
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Telephone | 888-938-3838
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Fax | 888-919-1083
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 55650
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 76417
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License Number State | WI
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