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Organization

JEANNETTE PONDER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JEANNETTE PONDER (LPN RCS)
(414) 447-1489
Entity
Organization

Contact information

Practice address
3152 N 24TH PL, MILWAUKEE, WI 53206-1209
(414) 447-1489
Mailing address
3152 N 24TH PL, MILWAUKEE, WI 53206-1209
(414) 447-1489

Taxonomy

Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
11818
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39973100
WI
Enumeration date
04/06/2006
Last updated
08/22/2020
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