Individual
JESSICA R MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
102 N WASHINGTON ST, GREEN BAY, WI 54301-4209
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
14135-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100251462
—
WI
Enumeration date
08/01/2023
Last updated
01/18/2024
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