Chilsen, Jody M
Chilsen, Jody M is an individual health care provider with primary practice located at 2321 Stout Rd , Menomonie WI 54751-7003. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Chilsen, Jody M can be contacted via phone (715) 235-5531.Contact Information
Primary practice address
2321 Stout Rd
Menomonie WI 54751-7003
Phone: (715) 235-5531
Fax: (715) 233-7645
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 701-023 | Wisconsin |
Profile Details
| NPI number | 1184629172 |
|---|---|
| LBN Legal business name | Chilsen, Jody M |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1184629172 | NPPES |
| Wisconsin | MEDICAID | 42940000 |
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