Individual
JEANNE FLEAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY, 106, MILWAUKEE, WI 53215-3677
(414) 649-3300
(414) 649-7012
Mailing address
2901 W KINNICKINNIC RIVER PKWY, 106, MILWAUKEE, WI 53215-3677
(414) 649-3300
(414) 649-7012
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
7347
WI
363LA2200X
Adult Health Nurse Practitioner
990130
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740535186
—
WI
Enumeration date
07/23/2012
Last updated
01/03/2017
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