Individual
JESSICA DE VALK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7322 W RAWSON AVE, FRANKLIN, WI 53132-8117
(414) 433-9010
(414) 433-9007
Mailing address
9000 W WISCONSIN AVE # MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
68053-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528421013
—
WI
Enumeration date
04/01/2016
Last updated
07/26/2019
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