Individual
DR. JESSICA LOVE THOMASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4914 W PARKVIEW DR, MEQUON, WI 53092-2027
(262) 242-2014
(262) 242-2014
Mailing address
4914 W PARKVIEW DR, MEQUON, WI 53092-2027
(262) 242-2014
(262) 242-2014
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
25873-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25873-20
STATE LICENSE NUMBER
WI
Enumeration date
06/21/2010
Last updated
03/07/2023
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