Jodat, Nicole Marie
Jodat, Nicole Marie is an individual health care provider with primary practice located at 601 N Barker Rd Ste 110 , Brookfield WI 53045-5929. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Jodat, Nicole Marie can be contacted via phone (262) 785-0777.Contact Information
Primary practice address
601 N Barker Rd Ste 110
Brookfield WI 53045-5929
Phone: (262) 785-0777
Fax: (262) 785-8029
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 2335-023 | Wisconsin |
Profile Details
| NPI number | 1871742627 |
|---|---|
| LBN Legal business name | Jodat, Nicole Marie |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 17th, 2008 |
| Last updated | Apr 3rd, 2020 - about 6 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 | 1871742627 | NPPES |
| Wisconsin | MEDICAID | 1871742627 |
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