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General NPI Number Information
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NPI Number | 1528449568
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Entity Type | Individual
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Provider Name | JENNA LEASE RN, APNP
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Gender | Female
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Dates
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Enumeration Date | 06/16/2015
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Last Update Date | 05/16/2019
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Provider Practice Location Address
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Address Line | W180N8000 TOWN HALL RD
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-4002
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Country | US
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Telephone | 262-532-3850
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Fax |
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Provider Business Mailing Address
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Address Line | W180N8000 TOWN HALL RD
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-4002
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Country | US
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Telephone | 715-432-5366
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | 6276
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License Number State | WI
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