Individual
LUIS FERNANDO JASSO CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
W263N2060 E FIELDHACK DR UNIT 205, PEWAUKEE, WI 53072-5405
(414) 243-4900
Mailing address
W263N2060 E FIELDHACK DR UNIT 205, PEWAUKEE, WI 53072-5405
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18326-33
WI
Other
Enumeration date
06/11/2026
Last updated
06/11/2026
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