Individual provider · Type 1 NPI

Jordan Lyn Fenney

Student in an Organized Health Care Education/Training Program · West Bend, WI

NPI number 1912410028 Active

Practice location

4907 Hillside Dr
West Bend, WI 53095-9255

Call (262) 224-5151 Map

Fax (262) 224-5151

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1912410028

Jordan Lyn Fenney's National Provider Identifier is 1912410028, issued on Nov 10, 2017. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in West Bend, WI. The record was last updated on Nov 10, 2017.