Killeen, Jennifer L

Killeen, Jennifer L is an individual health care provider with primary practice located at 3727 W Wisconsin Ave , Milwaukee WI 53208-3182. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Other Service Providers / Midwife. Other Service Providers / Midwife is her primary health care specialty. Killeen, Jennifer L can be contacted via phone (414) 291-2626.

Contact Information

Primary practice address
3727 W Wisconsin Ave Milwaukee WI 53208-3182
Phone: (414) 291-2626
Fax: (414) 431-0050
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 146124-030 Wisconsin
Other Service Providers / Midwife 176B00000X 148825-32 Wisconsin

Profile Details

NPI number 1972750578
LBN Legal business name Killeen, Jennifer L
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 26th, 2008
Last updated Jul 25th, 2013 - about 12 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 1972750578 NPPES
Wisconsin MEDICAID 36091200

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