Individual
TAJANA JOVICIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11430 N PORT WASHINGTON RD, MEQUON, WI 53092-3414
(262) 518-1900
Mailing address
11430 N PORT WASHINGTON RD, MEQUON, WI 53092-3414
(262) 518-1900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10395
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10395
FNP
WI
Enumeration date
10/13/2020
Last updated
05/09/2023
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