Individual
JENNIFER L. SPADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1310 BROADWAY, WISCONSIN DELLS, WI 53965-1358
(608) 253-1171
(608) 253-8012
Mailing address
1310 BROADWAY, WISCONSIN DELLS, WI 53965-1358
(608) 253-1171
(608) 253-8012
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3692-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528443108
—
WI
Enumeration date
07/24/2015
Last updated
07/25/2016
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