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Individual

MS. JESSICA MARIE LILLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.P.N.P

Contact information

Practice address
1265 W AMERICAN DR STE 100, NEENAH, WI 54956
(920) 722-7747
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 886-8979

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2472-033
WI
363LF0000X
Family Nurse Practitioner
2472-033
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1932100096
WI
Enumeration date
08/10/2005
Last updated
08/15/2025
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