Individual
JENNIFER GUNDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1969 W HART RD, BELOIT, WI 53511-2230
(608) 364-5011
Mailing address
PO BOX 431, JANESVILLE, WI 53547-0431
(405) 696-7932
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
7374-23
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/01/2022
Last updated
01/30/2024
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