Individual
MR. JARED WILLIAM KIERNICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1970 S RIDGE RD, GREEN BAY, WI 54304-4125
(920) 430-4888
(920) 430-4889
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-2789
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10002329A
IN
363A00000X
Physician Assistant
Primary
5235-23
WI
363A00000X
Physician Assistant
PA2286
KY
Other
Enumeration date
02/28/2013
Last updated
06/02/2021
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