Individual
JENNA ANNE MIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
W168N11030 ASHBURY CIR, UNIT #1, GERMANTOWN, WI 53022-5575
(414) 779-0772
Mailing address
W168N11030 ASHBURY CIR, UNIT #1, GERMANTOWN, WI 53022-5575
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
18587030
WI
Other
Enumeration date
12/31/2016
Last updated
12/31/2016
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