Provider Demographics
NPI:1457879595
Name:ALMANZA, JENNIFER IRENE (CNM, RN, PHN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:IRENE
Last Name:ALMANZA
Suffix:
Gender:F
Credentials:CNM, RN, PHN
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS 21110Q
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 1:1654 DIFFLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2237
Practice Address - Country:US
Practice Address - Phone:651-641-3900
Practice Address - Fax:651-641-3904
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2021-06-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MNR-169659-4163W00000X
MN375367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse