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General NPI Number Information
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NPI Number | 1326895640
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Entity Type | Individual
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Provider Name | JENNIFER MARIANNE HUSSUNG RN, CWOCN
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Gender | Female
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Dates
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Enumeration Date | 05/03/2024
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Last Update Date | 05/03/2024
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Provider Practice Location Address
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Address Line | 1 VETERANS DR
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City | MINNEAPOLIS
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State | MN
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Zip | 55417-2309
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Country | US
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Telephone | 612-467-5877
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Fax |
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Provider Business Mailing Address
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Address Line | 20853 HARTFORD WAY
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City | LAKEVILLE
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State | MN
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Zip | 55044-4790
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Country | US
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Telephone | 952-807-2192
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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 | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 2139005
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License Number State | MN
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