Individual
EVAN JURGENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-2000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8629
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100388562
—
WI
Enumeration date
07/24/2025
Last updated
01/28/2026
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