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General NPI Number Information
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NPI Number | 1851745103
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Entity Type | Individual
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Provider Name | JENNIFER MINOR M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 1818 N MEADE ST
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City | APPLETON
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State | WI
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Zip | 54911-3454
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Country | US
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Telephone | 920-731-4101
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Fax | 920-735-7618
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Provider Business Mailing Address
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Address Line | 3 NEENAH CTR
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City | NEENAH
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State | WI
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Zip | 54956-3070
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Country | US
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Telephone | 920-830-5900
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Fax | 920-830-5910
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | LL3333
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 3564
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License Number State | WI
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