Search › Wisconsin › 363A00000X
Jaclyn Green
NPI 1114650413 · on the registry since 2022 · sole proprietor
Practice
- Address
- 1312 E Oklahoma Ave
Milwaukee, WI 53207 - Phone
- (414) 595-4570
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 390200000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-07-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin