MEDICARE: JENNA PLAISANCE

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
1	224Y00000X	Clinical Exercise Physiologist		MN

General Provider Information

NPI Number	:	1730021262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA PLAISANCE

Provider Business Mailing Address
First Line	:	2917 HAMPSHIRE AVE S
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55426-3315
Country	:	US
Telephone Number	:	320-828-3460
Fax Number	:

Provider Business Practice Location Address
First Line	:	7450 FRANCE AVE S STE 240
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-4792
Country	:	US
Telephone Number	:	952-247-4785
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “ JENNA PLAISANCE ” Practice Location

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