Provider Demographics
NPI:1336443191
Name:HSU, JENNY ANN
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:ANN
Last Name:HSU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:ALENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3625 W 65TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2106
Mailing Address - Country:US
Mailing Address - Phone:952-920-7001
Mailing Address - Fax:952-345-0472
Practice Address - Street 1:3625 W 65TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2106
Practice Address - Country:US
Practice Address - Phone:952-920-7001
Practice Address - Fax:952-345-0472
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR176355-3363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology