Individual
JESSICA PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-5000
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(262) 434-5000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
5853-23
WI
363A00000X
Physician Assistant
Primary
5853
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100217866
—
WI
Enumeration date
08/30/2022
Last updated
02/06/2023
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