Provider Demographics
NPI:1881990588
Name:SOMMERFELD, JENNIFER LYN (RN)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYN
Last Name:SOMMERFELD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 S SWIFT AVE
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55355-3353
Mailing Address - Country:US
Mailing Address - Phone:320-444-7347
Mailing Address - Fax:
Practice Address - Street 1:603 S SWIFT AVE
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55355-3353
Practice Address - Country:US
Practice Address - Phone:320-444-7347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR154122-5163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse