Jodat, Nicole Marie

Jodat, Nicole Marie is an individual health care provider with primary practice located at 601 N Barker Rd Ste 110 , Brookfield WI 53045-5929. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Jodat, Nicole Marie can be contacted via phone (262) 785-0777.

Contact Information

Primary practice address
601 N Barker Rd Ste 110 Brookfield WI 53045-5929
Phone: (262) 785-0777
Fax: (262) 785-8029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 2335-023 Wisconsin

Profile Details

NPI number 1871742627
LBN Legal business name Jodat, Nicole Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2008
Last updated Apr 3rd, 2020 - 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 1871742627 NPPES
Wisconsin MEDICAID 1871742627

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