Individual
JENNIFER PREM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
S77W19857 HOLLY PATCH CT, MUSKEGO, WI 53150-8781
(262) 900-6037
Mailing address
S77W19857 HOLLY PATCH CT, MUSKEGO, WI 53150-8781
(262) 900-6037
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
14991
WI
163W00000X
Registered Nurse
Primary
149991-30
WI
Other
Enumeration date
02/23/2022
Last updated
02/23/2022
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