Healthcare Provider Details

I. General information

NPI: 1851619829
Provider Name (Legal Business Name): JENNIFER L. DUMKE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER L. OSTROWSKI

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8905 W LINCOLN AVE SUITE 501
WEST ALLIS WI
53227-2468
US

IV. Provider business mailing address

3003 W GOOD HOPE RD
MILWAUKEE WI
53209-2042
US

V. Phone/Fax

Practice location:
  • Phone: 414-978-2229
  • Fax: 414-978-2279
Mailing address:
  • Phone: 414-352-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4238
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: