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Individual

MISS CHRISTINE MARIE JOHNROE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2901 W KINNICKINNIC RIVER PKWY, STE. 201, MILWAUKEE, WI 53215-3677
(414) 644-9323
Mailing address
2901 W KINNICKINNIC RIVER PKWY, SUITE 201, MILWAUKEE, WI 53215-3677
(414) 649-3232

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.004574
IL
363A00000X
Physician Assistant
Primary
310523
WI
363AS0400X
Surgical Physician Assistant
310523
WI

Other

Enumeration date
12/02/2012
Last updated
09/06/2013
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