Provider Demographics
NPI:1467234971
Name:PAPENFUSS, JENNIE LYNN
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:LYNN
Last Name:PAPENFUSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT THOMAS
Mailing Address - State:ND
Mailing Address - Zip Code:58276-4100
Mailing Address - Country:US
Mailing Address - Phone:701-360-1087
Mailing Address - Fax:
Practice Address - Street 1:525 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT THOMAS
Practice Address - State:ND
Practice Address - Zip Code:58276-4100
Practice Address - Country:US
Practice Address - Phone:701-360-1087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant