Individual
AMANDA JANCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-5800
(414) 805-8097
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-5800
(414) 805-8097
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4435-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952872376
—
WI
Enumeration date
12/11/2018
Last updated
03/14/2023
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