Provider Demographics
NPI:1346872132
Name:KUIKEN, JENNA HYE MIN (DC)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:HYE MIN
Last Name:KUIKEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:HYE
Other - Middle Name:MIN
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2050 SAINT CLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-1650
Mailing Address - Country:US
Mailing Address - Phone:651-888-2294
Mailing Address - Fax:
Practice Address - Street 1:2050 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-1650
Practice Address - Country:US
Practice Address - Phone:651-888-2294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-10
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6695111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor