MEDICARE: JESSICA PASQUAN NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	143500	WI
2	363L00000X	Nurse Practitioner	5611	WI

General Provider Information

NPI Number	:	1518397660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA PASQUAN NP

Provider Business Mailing Address
First Line	:	7974 UW HEALTH CT
Second Line	:
City	:	MIDDLETON
State	:	WI
Zip	:	53562-5531
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 DELAPLAINE CT
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53715-1840
Country	:	US
Telephone Number	:	608-241-9020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2013
Last Update Date	:	01/12/2021

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