Individual
JESSICA KUENNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY STE 880, MILWAUKEE, WI 53215-3678
(414) 649-3370
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4417
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080142
—
WI
05
—
1295229805
—
WI
Enumeration date
06/18/2018
Last updated
09/03/2024
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