Individual
JESSICA VITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226
(414) 805-8700
(414) 259-1522
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8700
(414) 259-1522
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
85
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730580846
—
WI
Enumeration date
09/08/2014
Last updated
07/17/2018
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