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NPI Code Detail

MEDICARE: MRS. JENNIFER GRACE DOERFER NP-C

MEDICARE: MRS. JENNIFER GRACE DOERFER NP-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
1363LF0000XFamily Nurse Practitioner4704364760MI
2363LF0000XFamily Nurse Practitioner5859-33WI

General Provider Information

NPI Number : 1932500808
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER GRACE DOERFER NP-C
Provider Business Mailing Address
First Line : FROEDTERT & MCW FASTCARE
Second Line : 5800 W LAYTON AVE
City : GREENFIELD
State : WI
Zip : 53220-4021
Country : US
Telephone Number : 414-805-9959
Fax Number :
Provider Business Practice Location Address
First Line : FROEDTERT & MCW FASTCARE
Second Line : 5800 W LAYTON AVE
City : GREENFIELD
State : WI
Zip : 53220-4021
Country : US
Telephone Number : 414-805-9959
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2014
Last Update Date : 09/11/2023

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