Individual
MRS. JENNIFER J LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
4131 W LOOMIS RD, SUITE 300, GREENFIELD, WI 53221-2057
(414) 325-7246
(414) 325-3770
Mailing address
4131 W LOOMIS RD, SUITE 300, GREENFIELD, WI 53221-2057
(414) 325-7246
(414) 325-3770
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
164569-30
WI
363LA2200X
Adult Health Nurse Practitioner
Primary
5335-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538152491
—
WI
Enumeration date
07/10/2013
Last updated
02/23/2016
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