Individual
MRS. JESSICA LOREN MCNULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC EMERGENCY MEDICINE, MILWAUKEE, WI 53226-4874
(414) 266-2625
(414) 266-2635
Mailing address
250 E. ERIE ST., CHICAGO, IL 60686
(708) 369-9781
(414) 266-2635
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085005379
IL
363A00000X
Physician Assistant
2993
WI
Other
Enumeration date
07/16/2012
Last updated
10/02/2017
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