Provider Demographics
NPI:1811975956
Name:JENKINS, DAWN MERSCH (MD)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MERSCH
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:KATHERINE
Other - Last Name:MERSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1515 ST. FRANCIS AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379
Mailing Address - Country:US
Mailing Address - Phone:952-993-3282
Mailing Address - Fax:952-993-7813
Practice Address - Street 1:1515 ST. FRANCIS AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379
Practice Address - Country:US
Practice Address - Phone:952-993-3282
Practice Address - Fax:952-993-7813
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34454207V00000X
MN50666207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNI48984Medicare UPIN