Individual
JENNIFER MICHELLE PONFIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
321 IDAHO ST, OSHKOSH, WI 54902-5820
(715) 280-0018
Mailing address
321 IDAHO ST, OSHKOSH, WI 54902-5820
(715) 280-0018
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
190206
WI
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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