Individual
JESSE SELESTOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY STE 680, MILWAUKEE, WI 53215-3633
(414) 385-1922
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8208-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100074549
—
WI
Enumeration date
01/12/2018
Last updated
01/22/2024
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