Ironside, Jay P

Ironside, Jay P is an sole proprietor health care provider with primary practice located at 80 1St St , Prairie Du Sac WI 53578-1550. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Ironside, Jay P can be contacted via phone (608) 643-7299.

Contact Information

Primary practice address
80 1St St Prairie Du Sac WI 53578-1550
Phone: (608) 643-7299
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 147652 Wisconsin

Profile Details

NPI number 1578520136
LBN Legal business name Ironside, Jay P
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 27th, 2006
Last updated May 23rd, 2013 - about 13 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 1578520136 NPPES
Wisconsin MEDICAID 43331500

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