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NPI Code Detail

MEDICARE: DR. JENNIFER ELAINE MUELLER M.D.

MEDICARE: DR. JENNIFER ELAINE MUELLER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD171189OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MD171189OTHEROROR MEDICAL LICENSE

General Provider Information

NPI Number : 1093740268
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER ELAINE MUELLER M.D.
Provider Business Mailing Address
First Line : PO BOX 568
Second Line :
City : CORNELIUS
State : OR
Zip : 97113-0568
Country : US
Telephone Number : 503-352-8642
Fax Number : 503-352-8648
Provider Business Practice Location Address
First Line : 115 NE MAY LN
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-9272
Country : US
Telephone Number : 503-472-1338
Fax Number : 503-434-8597
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 07/07/2015

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