Provider Demographics
NPI:1952644841
Name:GIOIA, JENNIFER SUE (CRNA)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:SUE
Last Name:GIOIA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:S
Other - Last Name:JERDEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:16610 54TH AVE N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-3837
Mailing Address - Country:US
Mailing Address - Phone:712-490-8476
Mailing Address - Fax:
Practice Address - Street 1:16610 54TH AVE N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-3837
Practice Address - Country:US
Practice Address - Phone:712-490-8476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-29
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 208422-8163W00000X
MN2201367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse