Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jenna J Mulder

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1053929653

Jenna J Mulder is a Physician Assistant in Shawano, Wisconsin. Qualified in 2020, 6 years ago. Practices with Surgical Associates of Neenah, SC, a 29-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2020
Specialties on file
2

Practice location Address checks out

100 County Road B
Shawano, WI 54166-7072
Phone: (715) 526-2111
Fax: (715) 526-9366
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5218 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1053929653
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 20, 2020
Last updated in NPPESMarch 22, 2021
Certification dateMarch 22, 2021
Mailing address3 Neenah Ctr Fl 5, Neenah, WI 54956-3070

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Surgical Associates Of Neenah, S.C. — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Shawano