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Individual

MRS. JESSICA DARCY FODROCY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-1400
(414) 955-0197
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-1400
(414) 955-0197

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
257680-30
WI
363L00000X
Nurse Practitioner
Primary
10649-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1215524731
WI
Enumeration date
12/30/2020
Last updated
03/03/2023
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