Individual
MRS. JENNIFER LYNN INGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA066032
PA
363AS0400X
Surgical Physician Assistant
Primary
1159023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386774966
—
WI
Enumeration date
03/06/2007
Last updated
03/03/2025
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