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NPI Code Detail

MEDICARE: JENNIFER CAROL ROBERTS MD

MEDICARE: JENNIFER CAROL ROBERTS MD
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
1208600000XSurgery Physician5241820WI
22086S0102XSurgical Critical Care Physician5241820WI
3207RC0200XCritical Care Medicine (Internal Medicine) Physician5241820WI

General Provider Information

NPI Number : 1770658890
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER CAROL ROBERTS MD
Provider Business Mailing Address
First Line : 3 NEENAH CTR
Second Line :
City : NEENAH
State : WI
Zip : 54956-3070
Country : US
Telephone Number : 920-830-5900
Fax Number : 920-830-5910
Provider Business Practice Location Address
First Line : 1000 N OAK AVE
Second Line :
City : MARSHFIELD
State : WI
Zip : 54449-5703
Country : US
Telephone Number : 715-387-5511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2006
Last Update Date : 12/02/2025

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