Individual
JACQUELYN PARADISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN NNP-BC APNP
Contact information
Practice address
8915 W CONNELL AVE, MILWAUKEE, WI 53226-3067
(414) 241-7583
Mailing address
8915 W CONNELL AVE, MILWAUKEE, WI 53226-3067
(414) 241-7583
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
194720-30
WI
363LN0000X
Neonatal Nurse Practitioner
Primary
8975-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669712535
—
WI
Enumeration date
02/28/2013
Last updated
05/02/2024
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