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Contact Information

JAENA J WISNIEWSKI, MD
2945 HAZELWOOD ST STE 310
MAPLEWOOD, MN55109-1244
 Phone: 651-264-1500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for JAENA J WISNIEWSKI · (Female)

NPI Number 1710032594
Status Active
Credentials MD
Entity Individual
Enumeration date 01/24/2007
Last updated 02/18/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MN License # 52638
  • WI License # 68895-20
  • MN Medicaid ENROLLED
Hospital affiliation(s)
  • GLENCOE REGIONAL HEALTH SERVICES - (Critical Access)
    1805 HENNEPIN AVENUE NORTH
    GLENCOE, MN 55336
  • HEALTHEAST ST JOHN'S HOSPITAL - (Acute Care)
    1575 BEAM AVENUE
    MAPLEWOOD, MN 55109
  • HEALTHEAST WOODWINDS HOSPITAL - (Acute Care)
    1925 WOODWINDS DRIVE
    WOODBURY, MN 55125
  • SPOONER HEALTH SYS - (Critical Access)
    819 ASH STREET
    SPOONER, WI 54801
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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