Lange, Jennifer L

Lange, Jennifer L is an individual health care provider with primary practice located at 11051 N Sherman Rd , Edgerton WI 53534-9002. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Lange, Jennifer L can be contacted via phone (608) 884-3354.

Contact Information

Primary practice address
11051 N Sherman Rd Edgerton WI 53534-9002
Phone: (608) 884-3354
Fax: (608) 884-5022
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 8411 Wisconsin

Profile Details

NPI number 1417400490
LBN Legal business name Lange, Jennifer L
Credentials APNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2016
Last updated Mar 28th, 2022 - about 3 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 1417400490 NPPES
Wisconsin MEDICAID 1417400490

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