Healthcare Provider Details

I. General information

NPI: 1932297140
Provider Name (Legal Business Name): JENNIFER NICOLE SCHREIBER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER NICOLE CUNNINGHAM M.D.

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 03/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12635 W. BLUEMOUND ROAD
BROOKFIELD WI
53005-8004
US

IV. Provider business mailing address

9000 W WISCONSIN AVE MS 958
MILWAUKEE WI
53226-4874
US

V. Phone/Fax

Practice location:
  • Phone: 414-258-0606
  • Fax: 414-258-1953
Mailing address:
  • Phone: 414-266-7615
  • Fax: 414-266-6238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number50174
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: