Provider Demographics
NPI:1447318316
Name:HARRINGTON, JENNIFER LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:750 S 2ND ST APT 502
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-2364
Mailing Address - Country:US
Mailing Address - Phone:651-290-7600
Mailing Address - Fax:763-413-7169
Practice Address - Street 1:2805 CAMPUS DR
Practice Address - Street 2:SUITE 485
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-2676
Practice Address - Country:US
Practice Address - Phone:651-290-7600
Practice Address - Fax:763-413-7169
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN379882086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1300076OtherMEDICA CHOICE
MN01024742OtherPREFERRED ONE
MN7093250-00Medicaid
MN22D40HAOtherBLUE CROSS BLUE SHIELD
MN70193OtherHEALTH PARTNERS
MNG09421Medicare UPIN