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Individual

JENNIFER D. ROELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
N84W16889 MENOMONEE AVE, MENOMONEE FALLS, WI 53051-2810
(262) 251-7500
(262) 251-7128
Mailing address
PO BOX 375044, CHICAGO, IL 60673-0001
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1071
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42978700
WI
Enumeration date
07/04/2006
Last updated
07/16/2024
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