Individual
JAKE CARPENTER QUINN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C, MSPAS
Contact information
Practice address
705 S UNIVERSITY AVE STE 200, BEAVER DAM, WI 53916-3079
(920) 887-9272
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
8017
WI
Other
Enumeration date
08/25/2022
Last updated
02/26/2025
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