Individual
JENNIFER CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8915 W CONNELL AVE, MILWAUKEE, WI 53226-3067
(414) 266-8427
Mailing address
4689 PARKWOOD DR SE, PRIOR LAKE, MN 55372-3358
(952) 270-0841
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7754-23
WI
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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