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NPI Code Detail

MEDICARE: DR. JENNIFER ALLIE AU.D

MEDICARE: DR. JENNIFER ALLIE AU.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
1231H00000XAudiologistMN
2231H00000XAudiologist8299MN

General Provider Information

NPI Number : 1487829560
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER ALLIE AU.D
Provider Business Mailing Address
First Line : 500 S MAPLE ST
Second Line :
City : WACONIA
State : MN
Zip : 55387-1791
Country : US
Telephone Number : 952-442-2191
Fax Number : 952-442-8055
Provider Business Practice Location Address
First Line : 111 HUNDERTMARK RD STE 115N
Second Line :
City : CHASKA
State : MN
Zip : 55318-1584
Country : US
Telephone Number : 952-361-2450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2008
Last Update Date : 11/09/2018

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