Miesfeld, Jessica L
Miesfeld, Jessica L is an individual health care provider with primary practice located at 109 Warren St Ste 4, Beaver Dam WI 53916-3082. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Miesfeld, Jessica L can be contacted via phone (920) 885-3305.Contact Information
Primary practice address
109 Warren St Ste 4
Beaver Dam WI 53916-3082
Phone: (920) 885-3305
Fax: (920) 885-5506
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 57522-20 | Wisconsin |
Profile Details
| NPI number | 1174841076 |
|---|---|
| LBN Legal business name | Miesfeld, Jessica L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2010 |
| Last updated | Feb 14th, 2014 - about 10 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 | 1174841076 | NPPES |
| Wisconsin | MEDICAID | 100031865 |
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