Wilde, Jodi L

Wilde, Jodi L is an individual health care provider with primary practice located at 4202 W Oakwood Park Ct Ste 200 , Franklin WI 53132-9565. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Wilde, Jodi L can be contacted via phone (414) 423-5250.

Contact Information

Primary practice address
4202 W Oakwood Park Ct Ste 200 Franklin WI 53132-9565
Phone: (414) 423-5250
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 151348 Wisconsin

Profile Details

NPI number 1598013534
LBN Legal business name Wilde, Jodi L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2012
Last updated Nov 7th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598013534 NPPES
Wisconsin MEDICAID 100026312

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