Altis, Jessica Helen

Altis, Jessica Helen is an individual health care provider with primary practice located at 11211 W Lincoln Ave Lincoln Avenue Clinic, West Allis WI 53227-1035. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Altis, Jessica Helen can be contacted via phone (414) 955-5900.

Contact Information

Primary practice address
11211 W Lincoln Ave Lincoln Avenue Clinic West Allis WI 53227-1035
Phone: (414) 955-5900
Fax: (414) 327-7639
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 278623 Wisconsin

Profile Details

NPI number 1841587029
LBN Legal business name Altis, Jessica Helen
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2011
Last updated Feb 15th, 2016 - about 9 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 1841587029 NPPES
Wisconsin MEDICAID 1841587029

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