Individual
JEFFREY ALLEN FILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APNP
Contact information
Practice address
1405 MILL ST, NEW LONDON, WI 54961-2155
(920) 531-2400
(920) 531-2450
Mailing address
96 N CLINTON AVE, CLINTONVILLE, WI 54929-1250
(715) 460-0347
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
10818-33
WI
363LF0000X
Family Nurse Practitioner
Primary
10818
WI
Other
Enumeration date
03/26/2021
Last updated
02/14/2022
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