Individual
MS. STEPHANIE JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
248 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 767-8000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2080
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41930000
—
WI
Enumeration date
11/13/2006
Last updated
03/01/2024
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