Individual provider · NPI-1

Brian L Jan, PA-C

Physician Assistant · Oak Creek, WI

NPI number1437183902
StatusActive
Last updated in NPPESAug 5, 2025

Details

NPI
1437183902
Entity type
Individual (NPI-1)
Name
Brian L Jan
Credential
PA-C
Sex
Male
Sole proprietor
No
Enumeration date
Jul 10, 2006
Certification date
Aug 5, 2025
Last updated
Aug 5, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant1524-023WIYes

Practice location

200 E Ryan Rd
Oak Creek, WI 53154-4563

Phone 414-570-4330 · Fax 414-570-7331

Mailing address

Po Box 735044
Chicago, IL 60673-5044

Phone 800-326-2250

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