Fosso, Jeffrey Merle

Fosso, Jeffrey Merle is an individual health care provider with primary practice located at 2422 North Grandview Blvd , Waukesha WI 53188. He recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Fosso, Jeffrey Merle can be contacted via phone (262) 549-6600.

Contact Information

Primary practice address
2422 North Grandview Blvd Waukesha WI 53188
Phone: (262) 549-6600
Fax: (262) 549-6698
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Addiction (Substance Use Disorder) 163WA0400X Wisconsin

Profile Details

NPI number 1295949006
LBN Legal business name Fosso, Jeffrey Merle
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295949006 NPPES
Wisconsin MEDICAID 42016100

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