Healthcare Provider Details

I. General information

NPI: 1144130998
Provider Name (Legal Business Name): JENNIFER YOLANDA PRICE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 W VLIET ST
MILWAUKEE WI
53208-2698
US

IV. Provider business mailing address

5518 N 11TH ST
MILWAUKEE WI
53209-5102
US

V. Phone/Fax

Practice location:
  • Phone: 414-212-2420
  • Fax: 414-212-2415
Mailing address:
  • Phone: 414-212-2420
  • Fax: 414-212-2415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number138476-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: