Individual
JESSICA J. EBBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 251-6100
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
(608) 251-6100
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
6629-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477996486
—
WI
Enumeration date
04/09/2013
Last updated
12/18/2020
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