Individual
DIPTI R JETHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-1000
(414) 384-2000
Mailing address
305 N 95TH ST, APT 123, MILWAUKEE, WI 53226-4478
(732) 895-0926
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5645-33
WI
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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