Individual
JENNA LEE FUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1201 S LEE ST, APPLETON, WI 54915-3723
(920) 858-3302
Mailing address
803 W BROWNING ST, APPLETON, WI 54914-2155
(920) 903-2274
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
320377
WI
Other
Enumeration date
03/22/2019
Last updated
03/22/2019
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