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Individual

JOLENE M KOPPLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
110 E 5TH AVE, ANTIGO, WI 54409-2710
(715) 623-2351
Mailing address
3000 WESTHILL DR, SUITE 303, WAUSAU, WI 54401-3795
(715) 847-2304

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
462
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43840100
WI
Enumeration date
07/13/2006
Last updated
07/08/2007
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