Individual
JACKIE JULIE BUDYNEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, APNP
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY STE 507, MILWAUKEE, WI 53215-3660
(414) 649-3780
(414) 649-3794
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2377
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
155-059-30
WI
363L00000X
Nurse Practitioner
Primary
4212-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100036033
—
WI
Enumeration date
01/12/2008
Last updated
11/29/2021
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