Jeanetta, Joan Kristen
Jeanetta, Joan Kristen is an individual health care provider with primary practice located at 3500 Tower Ave , Superior WI 54880-5335. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Jeanetta, Joan Kristen can be contacted via phone (715) 395-5454.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 1763-154 | Wisconsin |
Profile Details
| NPI number | 1750455838 |
|---|---|
| LBN Legal business name | Jeanetta, Joan Kristen |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2006 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750455838 | NPPES |
| Wisconsin | MEDICAID | 42775100 |
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