Individual
JESSICA BOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
910 MANITOBA AVE, SOUTH MILWAUKEE, WI 53172-2134
(414) 252-2239
Mailing address
50 S B B KING BLVD, MEMPHIS, TN 38103-2626
(901) 436-1381
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10640-33
WI
363LF0000X
Family Nurse Practitioner
221696
WI
Other
Enumeration date
12/29/2020
Last updated
04/25/2022
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