IndividualActive
Jennifer Davis
NPI 1619490711 · Gerontology Nurse Practitioner · Waupun, WI
Provider details
- NPI number
- 1619490711
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 7769 (WI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
160 Gateway Dr
Waupun, WI 53963-2276
Phone: (920) 324-9899
Approximate (ZIP-level) locationGet directions
Mailing address
160 Gateway Dr
Waupun, WI 53963-2276
Registry dates
- Enumerated
- 2017-07-20
- Last updated
- 2023-10-10
- Certified
- 2023-10-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.