Individual
MRS. JACQUELINE K EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16505 W NATIONAL AVE, NEW BERLIN, WI 53151-5513
(262) 641-2300
(262) 641-2311
Mailing address
1923 W MCKINLEY AVE, MILWAUKEE, WI 53205-2035
(414) 334-8625
(262) 641-2300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2750-23
WI
Other
Enumeration date
06/08/2011
Last updated
12/14/2020
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