Individual
MRS. JESSICA L ACEVEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1104 N 118TH ST, WAUWATOSA, WI 53226-3339
(414) 943-3396
Mailing address
1104 N 118TH ST, WAUWATOSA, WI 53226-3339
(414) 943-3396
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
176602-30
WI
Other
Enumeration date
06/05/2011
Last updated
06/05/2011
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