Jolly, Christine M
Jolly, Christine M is an individual health care provider with primary practice located at 8600 75Th St Suite 101, Kenosha WI 53142-8200. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Jolly, Christine M can be contacted via phone (262) 652-9430.Contact Information
Primary practice address
8600 75Th St Suite 101
Kenosha WI 53142-8200
Phone: (262) 652-9430
Fax: (262) 652-9433
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 41723 | Wisconsin |
Profile Details
| NPI number | 1619962982 |
|---|---|
| LBN Legal business name | Jolly, Christine M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2005 |
| Last updated | Apr 8th, 2011 - about 13 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 | 1619962982 | NPPES |
| Wisconsin | MEDICAID | 32526900 |
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