JENNA WIEDEN (NPI# 1790191252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790191252 |
| Entity Type | Individual |
| Full Name | JENNA WIEDEN |
| Credential | PHD |
| Practice Address |
333 Main St N Ste 110 Stillwater MN 55082-5054 |
| Mailing Address |
8955 Jane Rd N Lake Elmo MN 55042-9512 |
| Practice Telephone | 6514259297 |
| Mailing Telephone | 6514285454 |
| Enumeration Date | 2014-07-05 |
| Last Update Date | 2020-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
LP6503 | MN | Behavioral Health & Social Service Providers |
| N | 103TS0200X |
Psychologist Specialization: School |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1440 Broadway, Suite #610, Oakland, CA 946122041 | 6514285454 |
| Street Address |
333 MAIN ST N STE 110 |
| City | STILLWATER |
| State | MN |
| Zip Code | 55082-5054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
| 1982238085 | Jerald Haley | Technician | 924 6th Ave. S., Stillwater, MN 55082 | 2020-02-27 |
| 1801457387 | Sun Trad Chin Acu Mn LLC | Acupuncturist | Compass Center for Healing, 116 Chestnut St. E., Stillwater, MN 55082 | 2019-06-25 |
| 1598243990 | Carlson Distinctive Dentistry, Pllc | Dentist | 1701 Curve Crest Blvd W Ste 100, Stillwater, MN 55082 | 2018-07-30 |
| 1073001624 | Lindsay Beth Briggs | Chiropractor | 200 Chestnut St E, Ste 202, Stillwater, MN 55082 | 2018-04-30 |
| 1578932943 | Group Health Plan, Inc | Family Medicine | 921 Greeley Street, Stillwater, MN 55082 | 2015-09-16 |
| 1184001919 | Grant Rohrig | Specialist/Technologist | 8727 Jeffrey Ave North, Stillwater, MN 55082 | 2015-04-30 |
| 1346688991 | Kellie Ann Seth | Chiropractor | 200 Chestnut St E Ste 202, Stillwater, MN 55082 | 2013-06-05 |
| 1770928426 | Rivertown Animal Hospital | Veterinarian | 135 New England Place, Stillwater, MN 55082 | 2013-05-08 |
| 1285929265 | Healtheast Medical Research Institute | Dietitian, Registered | 2900 Curve Crest Blvd, Stillwater, MN 55082 | 2011-06-17 |
| Find all providers in zip 55082 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861653750 | Kim Marie Gleich | Psychologist | 14949 62nd St N, Stillwater, MN 55082-6132 | 2008-06-23 |
| 1982817805 | Jane Louise Anglin | Psychologist | 6381 Osgood Ave N # C, Stillwater, MN 55082-6118 | 2007-05-07 |
| 1447301908 | Mary G Freitag | Psychologist | 10480 Perkins Ave N, Stillwater, MN 55082-9273 | 2007-01-12 |
| 1598820367 | Donae Verbena Gustafson | Psychologist | 6120 Oren Ave N, Stillwater, MN 55082-6155 | 2006-12-22 |
| 1376628164 | Bonnie Joy Scott | Psychologist | 215 W Mcelroy Rd, Suite 1, Stillwater, OK 74075-3537 | 2006-10-27 |
| 1952416638 | Camille Mary Kulka | Psychologist | 333 Main St N Ste 205, Stillwater, MN 55082-5054 | 2006-08-20 |
| 1609886407 | Patrick Edward Shields | Psychologist | 1940 Greeley St S, 202a, Stillwater, MN 55082-5097 | 2006-08-08 |
| 1316954746 | Lawrence Benjamin Fulgenzi | Psychologist | 6414 E 19th Ave, Stillwater, OK 74074-8472 | 2006-08-01 |
| 1669495453 | Barbara Walker | Psychologist | 375 Orleans St E, Stillwater, MN 55082-5830 | 2006-07-25 |
| 1063458008 | Laurie Patrice Clemens | Psychologist | 619 S Lowry St, Stillwater, OK 74074-3627 | 2006-06-20 |
| Find all providers in STILLWATER | ||||
| City | STILLWATER |
| Zip Code | 55082 |
Please comment or provide details below to improve the information on JENNA WIEDEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.