Family First Care Clinic, LLC
Organization Active NPI Primary Care Clinic/Center · Eagle, WI
NPI 1033701115 · NPPES record last updated Nov 12, 2021
Key facts
- NPI
- 1033701115
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- FAMILY FIRST CARE CLINIC, LLC
- Practice address
- 108 Grove St
Eagle, WI 53119-2249 - Phone
- (262) 594-7012
- Fax
- (313) 556-1364
- NPI assigned
- Feb 9, 2021
- Organization subpart
- No
Authorized official
- Name
- Jessica L Olson, APNP
- Title
- Owner
- Phone
- (262) 271-6280
Practitioners 1
-
Jessica Lynn Olson, APNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2216311 | Family First Care Clinic | Certificate of waiver | Mar 10, 2027 |
National Provider Directory
Locations
108 Grove St
Eagle, WI 53119
Phone (262) 594-7012
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
108 Grove St
Eagle, WI 53119-2249
Mailing address
2125 Penhurst Way
Waukesha, WI 53186-1224
Phone (262) 594-7012
Other providers in Eagle, WI
- Jennifer Brittany Behn
- Luke Bjorklund
- Jeane M Borkowski
- Kristine Louise Clark-Setnes
- Eagle Fire District
- Keith L Mausner MD SC
- Karen Jean Kennedy
- Kettle Moraine Fire District
- Angela T McAdams
- Marisa M Phillips
All providers in Eagle, WI · Primary Care Clinic/Center in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.