Individual
JENNIFER MICHELE PHILBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 E TYRANENA PARK RD, LAKE MILLS, WI 53551-9678
(920) 648-8393
(920) 648-3656
Mailing address
200 E TYRANENA PARK RD, LAKE MILLS, WI 53551-9678
(920) 648-8393
(920) 648-3656
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44305
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34210300
—
WI
Enumeration date
07/14/2006
Last updated
03/07/2023
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