Individual
JENNIFER LYNN DALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2475 N 124TH ST, BROOKFIELD, WI 53005-4630
(414) 455-0463
(262) 599-5962
Mailing address
2377 S 73RD ST, WEST ALLIS, WI 53219-1805
(262) 365-1276
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F06212637
WI
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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