Individual
MS. JESSEE TAYLOR URBAITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-4600
(414) 805-2934
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-4600
(414) 805-2934
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4361-23
WI
363AM0700X
Medical Physician Assistant
085.005796
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588003354
—
WI
01
—
4361-23
WI LICENSE
WI
Enumeration date
06/14/2013
Last updated
10/08/2021
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