Individual
JENNIFER L KILLEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
146124-030
WI
176B00000X
Midwife
Primary
148825-32
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36091200
—
WI
Enumeration date
08/26/2008
Last updated
07/25/2013
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