Pravechek, Jennifer Lee
Pravechek, Jennifer Lee is an individual health care provider with primary practice located at 555 Redbird Cir Suite 200, De Pere WI 54115-7977. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Pravechek, Jennifer Lee can be contacted via phone (920) 338-6820.Contact Information
Primary practice address
555 Redbird Cir Suite 200
De Pere WI 54115-7977
Phone: (920) 338-6820
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 285485 | Wisconsin |
Profile Details
| NPI number | 1679773915 |
|---|---|
| LBN Legal business name | Pravechek, Jennifer Lee |
| Credentials | NP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2007 |
| Last updated | Aug 21st, 2013 - about 11 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 | 1679773915 | NPPES |
| Wisconsin | MEDICAID | 36047500 |
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