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General NPI Number Information
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NPI Number | 1790891216
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Entity Type | Individual
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Provider Name | JENNIFER LEIGH GEURTS M.S.
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 01/18/2011
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Provider Practice Location Address
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Address Line | 9200 W WISCONSIN AVE DEPARTMENT OF SURGICAL ONCOLOGY
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City | MILWAUKEE
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State | WI
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Zip | 53226-3522
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Country | US
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Telephone | 414-805-5738
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Fax |
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Provider Business Mailing Address
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Address Line | 8701 W WATERTOWN PLANK RD HMGC-HRC
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City | MILWAUKEE
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State | WI
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Zip | 53226-3548
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Country | US
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Telephone | 414-456-5889
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Fax | 414-456-6516
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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 | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number |
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License Number State |
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