Jessica Street, RN, CHPPN
Registered Nurse, Pediatrics in West Bend, WI. Individual provider (NPI-1).
NPI number1649892977
StatusActive
Last updated in NPPESMay 8, 2020
Details
- NPI
- 1649892977
- Entity type
- Individual (NPI-1)
- Name
- Jessica Street
- Credential
- RN, CHPPN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 8, 2020
- Certification date
- May 8, 2020
- Last updated
- May 8, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0200X | Registered Nurse, Pediatrics | 245340-30 | WI | Yes |
| 163WH1000X | Registered Nurse, Hospice | 245340-30 | WI |
Practice location
843 Eastern Ave Apt 14West Bend, WI 53095-4834
Phone 352-241-0529
Mailing address
843 Eastern Ave Apt 14West Bend, WI 53095-4834
Phone 352-241-0529
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