Micke-Kopetsky, Jennifer R.

Micke-Kopetsky, Jennifer R. is an individual health care provider with primary practice located at 6425 W Mequon Rd , Mequon WI 53092-1855. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Micke-Kopetsky, Jennifer R. can be contacted via phone (262) 242-0051.

Contact Information

Primary practice address
6425 W Mequon Rd Mequon WI 53092-1855
Phone: (262) 242-0051
Fax: (262) 242-8927
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 28560 Wisconsin

Profile Details

NPI number 1871527341
LBN Legal business name Micke-Kopetsky, Jennifer R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Nov 23rd, 2021 - about 5 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 1871527341 NPPES
Wisconsin Other P00854893 RR MEDICARE
Wisconsin MEDICAID 31488700 RR MEDICARE

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