Individual
TERESA A. JEROFKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9200 W WISCONSIN AVE, DIVISION OF SURGICAL ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-5701
(414) 259-9225
Mailing address
10000 W INNOVATION DR, SUITE 300, MILWAUKEE, WI 53226-4837
(414) 456-5006
(414) 456-6259
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
149532-030
WI
363LA2100X
Acute Care Nurse Practitioner
Primary
149532
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043473242
—
WI
01
—
149532-030
STATE LICENSE
WI
Enumeration date
07/08/2008
Last updated
05/23/2011
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