Individual
KRISTA JELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3864 MAPLE GROVE DR APT 103, MADISON, WI 53719-1824
(608) 206-0524
Mailing address
13111 N PORT WASHINGTON RD, MEQUON, WI 53097-2416
(262) 243-7408
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
163769
WI
Other
Enumeration date
07/15/2019
Last updated
05/26/2021
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