Individual
JENNIFER RENEE CAPPELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5300 MEMORIAL DR, TWO RIVERS, WI 54241-3923
(920) 793-7300
Mailing address
5300 MEMORIAL DR, TWO RIVERS, WI 54241-3923
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
61571
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100036314
—
WI
Enumeration date
04/30/2012
Last updated
11/30/2021
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