Provider Demographics
NPI:1942662572
Name:REPETTO FRENETTE, JIMENA ANABEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JIMENA
Middle Name:ANABEL
Last Name:REPETTO FRENETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JIMENA
Other - Middle Name:ANABEL
Other - Last Name:REPETTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1885 PLAZA DR
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2979
Practice Address - Country:US
Practice Address - Phone:952-993-4001
Practice Address - Fax:952-993-4095
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN73312207Q00000X
CAA163319207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine