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NPI Code Detail

MEDICARE: MICHELLE CHRISTIANA JOCKIN PA C

MEDICARE: MICHELLE CHRISTIANA JOCKIN PA C
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
1363AM0700XMedical Physician Assistant3146AZ
2363A00000XPhysician Assistant2726WI

General Provider Information

NPI Number : 1659359123
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE CHRISTIANA JOCKIN PA C
Provider Business Mailing Address
First Line : 900 ILLINOIS AVE
Second Line :
City : STEVENS POINT
State : WI
Zip : 54481-3114
Country : US
Telephone Number : 715-346-5000
Fax Number :
Provider Business Practice Location Address
First Line : 900 ILLINOIS AVE
Second Line :
City : STEVENS POINT
State : WI
Zip : 54481-3114
Country : US
Telephone Number : 715-346-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2006
Last Update Date : 09/21/2016

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