Wooden, Jennifer

Wooden, Jennifer is an individual health care provider with primary practice located at 146 E Geneva Sq , Lake Geneva WI 53147-9694. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Wooden, Jennifer can be contacted via phone (262) 249-5000.

Contact Information

Primary practice address
146 E Geneva Sq Lake Geneva WI 53147-9694
Phone: (262) 249-5000
Fax: (262) 249-7143
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 76103 Wisconsin

Profile Details

NPI number 1467959643
LBN Legal business name Wooden, Jennifer
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2018
Last updated Dec 8th, 2021 - 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 1467959643 NPPES
Wisconsin MEDICAID 100182189

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