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General NPI Number Information
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NPI Number | 1215291711
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Entity Type | Individual
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Provider Name | JENNIFER FROMM CARROLL MD
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Gender | Female
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 7760 FRANCE AVE S STE 1000
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City | BLOOMINGTON
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State | MN
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Zip | 55435-5870
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Country | US
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Telephone | 952-746-6767
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Fax |
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Provider Business Mailing Address
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Address Line | 2550 UNIVERSITY AVE W STE 110N
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City | SAINT PAUL
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State | MN
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Zip | 55114-2001
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Country | US
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Telephone | 651-602-5309
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301100739
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License Number State | MI
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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 | 73726
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License Number State | MN
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