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NPI Code Detail

MEDICARE: JACQUELINE R FINK PA

MEDICARE: JACQUELINE R FINK PA
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
1363A00000XPhysician Assistant2020WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12020OTHERWILICENSE

General Provider Information

NPI Number : 1578576153
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE R FINK PA
Provider Business Mailing Address
First Line : 2400 E CAPITOL DR
Second Line :
City : APPLETON
State : WI
Zip : 54911-8728
Country : US
Telephone Number : 920-731-5811
Fax Number :
Provider Business Practice Location Address
First Line : 2400 E CAPITOL DR
Second Line :
City : APPLETON
State : WI
Zip : 54911-8728
Country : US
Telephone Number : 920-454-6290
Fax Number : 920-729-2238
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2006
Last Update Date : 04/04/2023

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Directions to “ JACQUELINE R FINK PA” Practice Location

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