Individual
JESSICA EWIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
W168N11237 WESTERN AVE, GERMANTOWN, WI 53022
(262) 253-5060
Mailing address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9204
(262) 329-1000
(262) 329-1001
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6449-33
WI
363LF0000X
Family Nurse Practitioner
6449-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100048335
—
WI
Enumeration date
08/10/2015
Last updated
12/06/2021
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