Moe, Jenna
Moe, Jenna is an individual health care provider with primary practice located at 945 N 12Th St , Milwaukee WI 53233-1305. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as her primary health care specialty. Moe, Jenna can be contacted via phone (414) 219-2000.Contact Information
Primary practice address
945 N 12Th St
Milwaukee WI 53233-1305
Phone: (414) 219-2000
Fax: (414) 385-1590
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant | 367H00000X | 511 | Wisconsin |
Profile Details
| NPI number | 1811606304 |
|---|---|
| LBN Legal business name | Moe, Jenna |
| Credentials | Associate of Arts (AA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 23rd, 2022 |
| Last updated | Dec 4th, 2023 - about 3 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 | 1811606304 | NPPES |
| Wisconsin | MEDICAID | 100228527 |
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