Individual
KRISTA K SKJERVEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-6000
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
(414) 805-6851
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2828
WI
363AM0700X
Medical Physician Assistant
Primary
2828-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881974947
—
WI
Enumeration date
08/22/2011
Last updated
12/08/2014
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