Individual
NIMO A JAMA I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4349 CRAWFORD DR, MADISON, WI 53711-4806
(614) 582-0978
Mailing address
4349 CRAWFORD DR, MADISON, WI 53711-4806
(614) 582-0978
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39-3403977
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39-3403977
—
WI
Enumeration date
10/21/2025
Last updated
10/21/2025
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