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General NPI Number Information
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NPI Number | 1871474304
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Entity Type | Organization
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Legal Business Name | JENOVA MEDICAL, LLC
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 810 CARDINAL LN STE 230
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City | HARTLAND
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State | WI
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Zip | 53029-2390
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Country | US
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Telephone | 262-370-1738
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Fax | 262-361-0689
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Provider Business Mailing Address
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Address Line | 810 CARDINAL LN STE 230
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City | HARTLAND
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State | WI
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Zip | 53029-2390
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Country | US
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Telephone | 262-370-1738
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Fax | 262-361-0689
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER N MCLEOD
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Credential | ANPN, FNP-BC
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Telephone | 262-424-0180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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