Provider Demographics
NPI:1871474304
Name:JENOVA MEDICAL, LLC
Entity type:Organization
Organization Name:JENOVA MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:N
Authorized Official - Last Name:MCLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:ANPN, FNP-BC
Authorized Official - Phone:262-424-0180
Mailing Address - Street 1:810 CARDINAL LN STE 230
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-2390
Mailing Address - Country:US
Mailing Address - Phone:262-370-1738
Mailing Address - Fax:262-361-0689
Practice Address - Street 1:810 CARDINAL LN STE 230
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-2390
Practice Address - Country:US
Practice Address - Phone:262-370-1738
Practice Address - Fax:262-361-0689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty