Jennifer M Pena, ANP, GNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R1542350 Issued in MN

Practice address

800 E 28TH St
Suite H2100
Minneapolis, MN 55407-3723

Phone

(612) 863-3900

Fax

(612) 863-1681

NPI assigned

Aug 31, 2006

Last updated

Aug 20, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Jennifer R Myers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250726400000",
    "number": "1558472860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "address_2": "MR 10809",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-4813",
            "fax_number": "612-262-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "address_2": "SUITE H2100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-3900",
            "fax_number": "612-863-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "ANP, GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "R1542350",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R1542350",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MYERS",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Pelzel
• Isabela Pena Pino, MD
• Vianey Occelly Pena Torres, MSW, LICSW
• Fernando A Pena, MD
• Jacqueline Pena
• Jessica Frances Pendal
• Sydney Nicole Pendergast, PHARMD
• Katherine Pendleton, LICSW
• Lisa Peng, DO
• Penn Avenue Family Dental

• Adult Health Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Adult Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.